Volumetric PET/CT parameters predict local response of head and neck squamous cell carcinoma to chemoradiotherapy

• Published in: Cancer medicine (Malden, MA) MA), 2014-10, Vol.3 (5), p.1368-1376
• Main Authors: Hanamoto, Atsushi, Tatsumi, Mitsuaki, Takenaka, Yukinori, Hamasaki, Toshimitsu, Yasui, Toshimichi, Nakahara, Susumu, Yamamoto, Yoshifumi, Seo, Yuji, Isohashi, Fumiaki, Ogawa, Kazuhiko, Hatazawa, Jun, Inohara, Hidenori
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cancer therapies; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - therapy; Chemoradiotherapy; Chemotherapy; Clinical Cancer Research; Clinical outcomes; Combined Modality Therapy; Disease; Female; Glycolysis; Head & neck cancer; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - therapy; head and neck squamous cell carcinoma; Human papillomavirus; Humans; Larynx; local response; Lymphatic system; Male; Medical prognosis; metabolic tumor volume; Metabolism; Middle Aged; Multivariate analysis; Neoplasm Metastasis; Neoplasm Staging; Odds Ratio; Oropharyngeal cancer; Positron emission tomography; Radiation therapy; Risk Factors; ROC Curve; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck; Tomography, X-Ray Computed; total lesion glycolysis; Treatment Outcome; Tumor Burden; Tumors
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.295

It is not well established whether pretreatment 18F‐FDG PET/CT can predict local response of head and neck squamous cell carcinoma (HNSCC) to chemoradiotherapy (CRT). We examined 118 patients: 11 with nasopharyngeal cancer (NPC), 30 with oropharyngeal cancer (OPC), and 77 with laryngohypopharyngeal cancer (LHC) who had completed CRT. PET/CT parameters of primary tumor, including metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum and mean standardized uptake value (SUVmax and SUVmean), were correlated with local response, according to primary site and human papillomavirus (HPV) status. Receiver‐operating characteristic analyses were made to access predictive values of the PET/CT parameters, while logistic regression analyses were used to identify independent predictors. Area under the curve (AUC) of the PET/CT parameters ranged from 0.53 to 0.63 in NPC and from 0.50 to 0.54 in OPC. HPV‐negative OPC showed AUC ranging from 0.51 to 0.58, while all of HPV‐positive OPCs showed complete response. In contrast, AUC ranged from 0.71 to 0.90 in LHC. Moreover, AUCs of MTV and TLG were significantly higher than those of SUVmax and SUVmean (P 25.0 mL and high TLG >144.8 g remained as independent, significant predictors of incomplete response compared with low MTV (odds ratio [OR], 13.4; 95% confidence interval [CI], 2.5–72.9; P = 0.003) and low TLG (OR, 12.8; 95% CI, 2.4–67.9; P = 0.003), respectively. In conclusion, predictive efficacy of pretreatment 18F‐FDG PET/CT varies with different primary sites and chosen parameters. Local response of LHC is highly predictable by volume‐based PET/CT parameters. It is not well established whether pretreatment 18F‐FDG PET/CT can predict local response of head and neck squamous cell carcinoma to chemoradiotherapy. Predictive efficacy of pretreatment 18F‐FDG PET/CT varies with different primary sites and chosen parameters. Local response of laryngohypopharyngeal cancer is highly predictable by volume‐based PET/CT parameters.