Use of pretreatment metabolic tumour volumes to predict the outcome of pharyngeal cancer treated by definitive radiotherapy

  • Chia-Hung Kao
  • Shih-Chieh Lin
  • Te-Chun Hsieh
  • Kuo-Yang Yen
  • Shih-Neng Yang
  • Yao-Ching Wang
  • Ji-An Liang
  • Chun-Hung Hua
  • Shang-Wen Chen
Original Article

Abstract

Purpose

The aim of the study was to investigate the predictive role of pretreatment metabolic volume (MTV) in pharyngeal cancer (PC) patients treated with definitive (chemo) radiotherapy.

Methods

This retrospective analysis enrolled 64 patients with PC treated with (chemo) radiotherapy. All patients received pretreatment fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT. Four PET segmentation methods were used, namely applying an isocontour at a standardized uptake value (SUV) of either 2.5 or 3.0 (MTV2.5 and MTV3.0) or using fixed thresholds of either 40 or 50 % (MTV40 %, MTV50 %) of the maximum intratumoural FDG activity. Disease-free survival (DFS) and primary relapse-free survival (PRFS) were examined according to cutoffs of the median values for each MTV and the gross tumour volume (GTVp). Independent prognosticators were identified by Cox regression analysis.

Results

With a median follow-up of 24 months, 19 patients died, and 26 patients experienced tumour relapse at primary sites. Multivariate analysis of the DFS showed that MTV2.5 > 13.6 ml was the only predictor of relapse [p = 0.011, hazard ratio = 2.69, 95 % confidence interval (CI) 1.25–5.76]. The independent predictor for PRFS was MTV2.5 > 13.6 ml (p = 0.003, hazard ratio = 3.76, 95 % CI 1.57–8.92), whereas GTVp > 15.5 ml had a marginal impact on PRFS (p = 0.06, hazard ratio = 3.54, 95 % CI 0.97–11.85). Patients having tumours with MTV2.5 > 13.6 ml had a significantly inferior 2-year PRFS compared with patients who had lower MTV2.5 tumours (39 vs 72 %, respectively, p = 0.001).

Conclusion

For PC patients treated with definitive (chemo)radiotherapy, pretreatment MTV2.5 volume achieved the best predictive value for primary recurrence, and the same value was also a prognosticator for DFS.

Keywords

FDG PET/CT Pharyngeal carcinoma Radiotherapy Metabolic tumour volume Prognostic factor 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Chia-Hung Kao
    • 1
    • 3
    • 7
  • Shih-Chieh Lin
    • 2
  • Te-Chun Hsieh
    • 1
  • Kuo-Yang Yen
    • 1
    • 5
  • Shih-Neng Yang
    • 2
    • 5
  • Yao-Ching Wang
    • 2
  • Ji-An Liang
    • 2
    • 3
  • Chun-Hung Hua
    • 6
  • Shang-Wen Chen
    • 2
    • 3
    • 4
    • 8
  1. 1.Department of Nuclear Medicine and PET CenterChina Medical University HospitalTaichungTaiwan
  2. 2.Department of Radiation OncologyChina Medical University HospitalTaichungTaiwan
  3. 3.Institute of Clinical Medicine Science and School of Medicine, College of MedicineChina Medical UniversityTaichungTaiwan
  4. 4.Institute of Clinical Medicine Science and School of MedicineTaipei Medical UniversityTaipeiTaiwan
  5. 5.Department of Biomedical Imaging and Radiological ScienceChina Medical UniversityTaichungTaiwan
  6. 6.Department of OtorhinolaryngologyChina Medical University HospitalTaichungTaiwan
  7. 7.Department of Nuclear Medicine and PET centerChina Medical University HospitalTaichungTaiwan
  8. 8.Department of Radiation OncologyChina Medical University HospitalTaichungTaiwan

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