Survival effect of pretreatment FDG-PET-CT on nasopharyngeal cancer

J Formos Med Assoc. 2023 Jan;122(1):36-46. doi: 10.1016/j.jfma.2022.07.012. Epub 2022 Aug 20.


Background/purpose: Accurate staging is the first step for optimal treatment selection in patients with nasopharyngeal carcinoma (NPC). In this propensity-score-matched, population-based cohort study, we investigated the survival effects of pretreatment 8-fluorodeoxyglucose positron emission tomography-computed tomography (18FDG-PET-CT) on patients with NPC.

Methods: We included patients with stage I-IVA NPC receiving radiotherapy or concurrent chemoradiotherapy and categorized them into two 1:1 propensity score-matched groups according to whether or not they underwent pretreatment 18FDG-PET-CT and compared their outcomes.

Results: Of the 10,756 patients, propensity score matching yielded 4366 patients in each group. According to multivariable Cox regression analyses, the most prominent correlation between pretreatment 18FDG-PET-CT and all-cause death was observed in patients with stage II NPC (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.60-0.90; P = .0433), followed by patients with stage III NPC (aHR, 0.81; 95% CI, 0.69-0.94; P = .0071) and patients with stage IVA NPC (aHR, 0.88; 95% CI, 0.79-0.97; P = .0091). This association was not significant in patients with stage I NPC (aHR, 1.20; 95% CI, 0.75-1.93; P = .4426).

Conclusion: Pretreatment 18FDG-PET-CT is associated with longer survival in patients with clinical stage II-IVA NPC but not in stage I NPC.

Keywords: (18)FDG-PET–CT; Clinical stages; Nasopharyngeal carcinoma; Radiotherapy; Survival.

MeSH terms

  • Cohort Studies
  • Fluorodeoxyglucose F18
  • Humans
  • Nasopharyngeal Carcinoma / diagnostic imaging
  • Nasopharyngeal Carcinoma / pathology
  • Nasopharyngeal Carcinoma / therapy
  • Nasopharyngeal Neoplasms* / diagnostic imaging
  • Nasopharyngeal Neoplasms* / pathology
  • Nasopharyngeal Neoplasms* / therapy
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography / methods
  • Positron-Emission Tomography / methods
  • Radiopharmaceuticals


  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals