Prognostic value of pre-treatment [18F] FDG PET/CT in recurrent nasopharyngeal carcinoma without distant metastasis

BMC Cancer. 2024 Apr 15;24(1):466. doi: 10.1186/s12885-024-12189-7.

Abstract

Background: [18 F]-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has the ability to detect local and/or regional recurrence as well as distant metastasis. We aimed to evaluate the prognosis value of PET/CT in locoregional recurrent nasopharyngeal (lrNPC).

Methods: A total of 451 eligible patients diagnosed with recurrent I-IVA (rI-IVA) NPC between April 2009 and December 2015 were retrospectively included in this study. The differences in overall survival (OS) of lrNPC patients with and without PET/CT were compared in the I-II, III-IVA, r0-II, and rIII-IVA cohorts, which were grouped by initial staging and recurrent staging (according to MRI).

Results: In the III-IVA and rIII-IVA NPC patients, with PET/CT exhibited significantly higher OS rates in the univariate analysis (P = 0.045; P = 0.009; respectively). Multivariate analysis revealed that with PET/CT was an independent predictor of OS in the rIII-IVA cohort (hazard ratio [HR] = 0.476; 95% confidence interval [CI]: 0.267 to 0.847; P = 0.012). In the rIII-IVA NPC, patients receiving PET/CT sacns before salvage surgery had a better prognosis compared with MRI alone (P = 0.036). The recurrent stage (based on PET/CT) was an independent predictor of OS. (r0-II versus [vs]. rIII-IVA; HR = 0.376; 95% CI: 0.150 to 0.938; P = 0.036).

Conclusion: The present study showed that with PET/CT could improve overall survival for rIII-IVA NPC patients. PET/CT appears to be an effective method for assessing rTNM staging.

Keywords: Locoregional recurrent; Nasopharyngeal carcinoma; TNM; [18F] FDG PET/CT.

MeSH terms

  • Fluorodeoxyglucose F18
  • Humans
  • Nasopharyngeal Carcinoma / diagnostic imaging
  • Nasopharyngeal Carcinoma / pathology
  • Nasopharyngeal Carcinoma / therapy
  • Nasopharyngeal Neoplasms* / diagnostic imaging
  • Nasopharyngeal Neoplasms* / pathology
  • Nasopharyngeal Neoplasms* / therapy
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography* / methods
  • Positron-Emission Tomography / methods
  • Prognosis
  • Radiopharmaceuticals
  • Retrospective Studies

Substances

  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals