Purpose: To evaluate prognostic value of pretreatment and posttreatment 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) in advanced hypopharyngeal carcinoma treated by chemoradiotherapy.
Procedures: Thirty-one patients underwent a baseline FDG-PET and then FDG-PET was repeated 7 weeks after chemoradiotherapy. Primary tumor uptake of FDG, measured as the maximal standardized uptake value (SUV(max)), was analyzed in relation to local control and survival.
Results: Neither local control nor cause-specific survival were associated with pretreatment SUV(max). In contrast, patients with a high posttreatment SUV(max) had significantly poorer local control (P = 0.002), as well as poorer cause-specific survival (P = 0.0075), compared to those with a low posttreatment SUV(max). This prognostic significance of posttreatment SUV(max) remained when only a subset of patients showing local complete response to chemoradiotherapy was analyzed.
Conclusions: Posttreatment FDG uptake represents an independent prognostic factor for hypopharyngeal carcinoma treated by chemoradiotherapy. Patients with a high posttreatment FDG uptake may benefit from adjuvant chemotherapy.