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18F-fluorodeoxyglucose positron emission tomography for predicting tumor response to radiochemotherapy in nasopharyngeal carcinoma

18F-Fluordesoxyglukose-Positronenemissionstomographie zur Vorhersage des Tumoransprechens auf eine Radiochemotherapie beim Nasopharynxkarzinom

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Abstract

Purpose

The aim of this study was to evaluate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting tumor response to radiochemotherapy in nasopharyngeal carcinoma (NPC).

Materials and methods

From July 2012 to March 2014, 46 NPC patients who had undergone PET scanning before receiving definitive intensity-modulated radiotherapy (IMRT) treatment in our hospital were enrolled. Factors potentially affecting tumor response to treatment were studied by multiple logistic regression analysis.

Results

After radiochemotherapy, 32 patients had a clinical complete response (CR), making the CR rate 69.6 %. Multiple logistic regression analysis demonstrated that the maximal standard uptake value (SUVmax) of the primary tumor was the only factor related to tumor response (p = 0.001), and that the logistic model had a high positive predictive value (90.6 %). The area under the receiver operating characteristic (ROC) curve was 0.809, with a best cutoff threshold at 10.05. Patients with SUVmax ≤ 10 had a higher CR rate than those with SUVmax > 10 (p < 0.001).

Conclusion

The SUVmax of the primary tumor before treatment is an independent predictor of tumor response in NPC.

Zusammenfassung

Ziel

Das Ziel der Arbeit bestand darin, den Wert der 18F-Fluordesoxyglukose-Positronenemissionstomographie (18F-FDG-PET) zur Vorhersage des Tumoransprechens auf eine Radiochemotherapie beim Nasopharynxkarzinom (NPC) zu beurteilen.

Patienten und Methoden

Von Juli 2012 bis März 2014 wurden 46 NPC-Patienten, die sich vor definitiver intensitätsmodulierter Strahlentherapie (IMRT) in unserem Krankenhaus einem PET-Scan unterzogen hatten, in die Studie aufgenommen. Faktoren, die möglicherweise das Tumoransprechen auf die Behandlung beeinflussen, wurden mittels multipler logistischer Regressionsanalyse untersucht.

Ergebnisse

Nach der Radiochemotherapie hatten 32 Patienten eine klinisch komplette Remission (CR), so dass eine CR-Rate von 69,6 % erreicht wurde. Die multiple logistische Regressionsanalyse zeigte, dass der SUVmax („standard uptake value“) des Primärtumors der einzige mit dem Tumoransprechen verbundene Faktor war (p = 0,001). Das logistische Modell hatte einen hohen positiven Vorhersagewert (90,6 %). Die Fläche unter der Grenzwertoptimierungskurve (ROC-Kurve) betrug 0,809, mit dem besten Schwellenwert bei 10,05. Patienten mit einem SUVmax unter 10 hatten eine höhere komplette Remissionsrate als Patienten mit einem SUVmax über 10 (p < 0,001).

Schlussfolgerung

Der SUVmax des Primärtumors vor der Behandlung ist ein unabhängiger Prädiktor für das Tumoransprechen bei NPC.

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Authors and Affiliations

  1. Department of Radiation Oncology and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Street, 325000, Wenzhou, Zhejiang province, P.R. China

    Meng Su, Hangping Wei, Ruifang Lin, Xuebang Zhang & Changlin Zou

  2. Department of Positron Emission Tomography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province, China

    Liang Zhao

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  1. Meng Su
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Correspondence to Changlin Zou.

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Conflict of interest

M. Su, L. Zhao, H. Wei, R. Lin, X. Zhang, and C. Zou state that there are no conflicts of interest.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Su, M., Zhao, L., Wei, H. et al. 18F-fluorodeoxyglucose positron emission tomography for predicting tumor response to radiochemotherapy in nasopharyngeal carcinoma. Strahlenther Onkol 191, 642–648 (2015). https://doi.org/10.1007/s00066-015-0842-2

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