Superior prognostic utility of gross and metabolic tumor volume compared to standardized uptake value using PET/CT in head and neck squamous cell carcinoma patients treated with intensity-modulated radiotherapy
To compare the prognostic utility of the 2-[18F] fluoro-2-deoxy-d-glucose (FDG) maximum standardized uptake value (SUVmax), primary gross tumor volume (GTV), and FDG metabolic tumor volume (MTV) for disease control and survival in patients with head and neck squamous cell carcinoma (HNSCC) undergoing intensity-modulated radiotherapy (IMRT).
Between 2007 and 2011, 41 HNSCC patients who underwent a staging positron emission tomography with computed tomography and definitive IMRT were identified. Local (LC), nodal (NC), distant (DC), and overall (OC) control, overall survival (OS), and disease-free survival (DFS) were assessed using the Kaplan–Meier product-limit method.
With a median follow-up of 24.2 months (range 2.7–56.3 months) local, nodal, and distant recurrences were recorded in 10, 5, and 7 patients, respectively. The median SUVmax, GTV, and MTV were 15.8, 22.2 cc, and 7.2 cc, respectively. SUVmax did not correlate with LC (p = 0.229) and OS (p = 0.661) when analyzed by median threshold. Patients with smaller GTVs (<22.2 cc) demonstrated improved 2-year actuarial LC rates of 100 versus 56.4 % (p = 0.001) and OS rates of 94.4 versus 65.9 % (p = 0.045). Similarly, a smaller MTV (<7.2 cc) correlated with improved 2-year actuarial LC rates of 100 versus 54.2 % (p < 0.001) and OS rates of 94.7 versus 64.2 % (p = 0.04). Smaller GTV and MTV correlated with improved NC, DC, OC, and DFS, as well.
GTV and MTV demonstrate superior prognostic utility as compared to SUVmax, with larger tumor volumes correlating with inferior local control and overall survival in HNSCC patients treated with definitive IMRT.
- Superior prognostic utility of gross and metabolic tumor volume compared to standardized uptake value using PET/CT in head and neck squamous cell carcinoma patients treated with intensity-modulated radiotherapy
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Annals of Nuclear Medicine
Volume 26, Issue 7 , pp 527-534
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Head and neck cancer
- Standardized uptake value (SUV)
- Gross tumor volume (GTV)
- Metabolic tumor volume (MTV)
- Intensity-modulated radiotherapy (IMRT)
- Industry Sectors
- Author Affiliations
- 1. Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building LL 238, Boston, MA, 02118, USA
- 2. Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 3. Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
- 4. Department of Otolaryngology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA