Impact of FDG-PET on prediction of clinical outcome after concurrent chemoradiotherapy in hypopharyngeal carcinoma

Mol Imaging Biol. Jan-Feb 2010;12(1):89-97. doi: 10.1007/s11307-009-0229-9. Epub 2009 May 7.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Hypopharyngeal Neoplasms / diagnostic imaging
  • Hypopharyngeal Neoplasms / drug therapy*
  • Hypopharyngeal Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Positron-Emission Tomography*
  • Prognosis
  • ROC Curve
  • Survival Analysis
  • Treatment Outcome
  • Young Adult

Substances

  • Fluorodeoxyglucose F18