Prognostic value of ¹⁸F-FDG PET-CT metabolic index for nasopharyngeal carcinoma

• Published in: Journal of cancer research and clinical oncology 2010-06, Vol.136 (6), p.883-889
• Main Authors: Xie, Peng, Yue, Jin-Bo, Zhao, Han-xi, Sun, Xin-Dong, Kong, Li, Fu, Zheng, Yu, Jin-Ming
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cancer Research; Carcinoma - diagnosis; Carcinoma - diagnostic imaging; Carcinoma - metabolism; Carcinoma - pathology; Carcinoma - therapy; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Disease-Free Survival; Dose Fractionation; Female; Fluorodeoxyglucose F18; Fluorouracil - administration & dosage; Head & neck cancer; Hematology; Humans; Internal Medicine; Kaplan-Meier Estimate; Male; Medical prognosis; Medical sciences; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Multivariate Analysis; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - diagnostic imaging; Nasopharyngeal Neoplasms - metabolism; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - therapy; Neoplasm Staging; Oncology; Original Paper; Otorhinolaryngology. Stomatology; Pharmacology. Drug treatments; Positron-Emission Tomography - methods; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Radiation therapy; Radiopharmaceuticals; Radiotherapy, Adjuvant; Radiotherapy, Intensity-Modulated; Retrospective Studies; ROC Curve; Sample Size; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-009-0729-7

Purpose The purpose of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) and metabolic index (MI) from fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in patients with nasopharyngeal carcinoma (NPC). Methods From October 2002 to July 2004, 41 patients with NPC who underwent ¹⁸F-FDG PET-CT scan before and after radiotherapy were reviewed retrospectively. All patients received intensity-modulated radiotherapy using 6MV X-rays. We examined the association of MTV and the results of long-term follow-up of the patients. Results Patients having tumors with an MTV below 30 cm³ had significantly better 5-year overall survival (OS) (84.6:46.7%, P = 0.006) and disease-free survival (DFS) (73.1:40.0%, P = 0.014) than patients with an MTV of 30 cm³ or greater. And the patients with MI below 130 had significantly higher 5-year OS (88.0:43.8%, P = 0.002) and DFS (76.0:37.5%, P = 0.005) than other patients. In the Cox multivariate analysis, MI and metabolic response (MR) were predictive of DFS, and we did not find a significant relationship between standard uptake value (SUV) and OS or DFS. Conclusions The present study shows that tumor volume parameters, especially the combination of MTV and SUV in the “metabolic index”, are valuable for predicting long-term survival. High MI may be useful for identifying patients requiring more aggressive treatment.