The relative prognostic utility of standardized uptake value, gross tumor volume, and metabolic tumor volume in oropharyngeal cancer patients treated with platinum based concurrent chemoradiation with a pre-treatment [18 F] fluorodeoxyglucose positron emission tomography scan

• Published in: Oral oncology 2014-09, Vol.50 (9), p.802-808
• Main Authors: Romesser, Paul B, Lim, Remy, Spratt, Daniel E, Setton, Jeremy, Riaz, Nadeem, Lok, Benjamin, Rao, Shyam, Sherman, Eric J, Schöder, Heiko, Lee, Nancy Y
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Combined Modality Therapy; Disease-Free Survival; Female; Fluorodeoxyglucose F18; Gross Tumor Volume (GTV); Head and neck cancer; Hematology, Oncology and Palliative Medicine; Humans; Male; Medical sciences; Metabolic Tumor Volume (MTV); Middle Aged; Oropharyngeal cancer; Oropharyngeal Neoplasms - diagnostic imaging; Oropharyngeal Neoplasms - drug therapy; Oropharyngeal Neoplasms - radiotherapy; Otolaryngology; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; PET; Positron-Emission Tomography - methods; Prognosis; Standardized Uptake Value (SUV); Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2014.06.018

Summary Objectives This study compared the relative prognostic utility of the Gross Tumor Volume (GTV), maximum Standardized Uptake Value (SUVmax ), and Metabolic Tumor Volume (MTV) in a uniform cohort of oropharyngeal squamous cell carcinoma (OPSCC) patients treated with platinum-based concurrent chemoradiation therapy (CCRT). Methods and materials One-hundred OPSCC with a pretreatment [18 F] fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET–CT) were treated with CCRT. Kaplan–Meier curves and Cox proportional hazard models were generated. Results When dichotomized by the median, a smaller MTV correlated with improved 5 year locoregional control (LRC) (98.0% versus 87.0%, p = 0.049), freedom from distant metastasis (FDM) (91.7% versus 65.0%, p = 0.005), progression-free survival (PFS) (80.3% versus 56.7%, p = 0.015), and overall survival (OS) (84.1% versus 57.8%, p = 0.008), whereas a smaller GTV correlated with improved PFS (80.3% versus 57.4%, p = 0.040) and OS (82.1% versus 60.1%, p = 0.025). SUVmax failed to correlate with any outcome. On multivariate analysis, when adjusted for GTV, T -stage, and N -stage a smaller MTV remained independently correlated with improved FDM, PFS, and OS. GTV failed to reach significance in the multivariate model. Conclusions A smaller MTV correlates with improved LRC, FDM, PFS, and OS in OPSCC patients undergoing platinum-based CCRT.