Pretreatment 18F-FDG PET standardized uptake value of primary tumor and neck lymph nodes as a predictor of distant metastasis for patients with nasopharyngeal carcinoma

Tsung Min Hung, Hung Ming Wang, Chung Jan Kang, Shiang Fu Huang, Chun Ta Liao, Sheng Chieh Chan, Shu Hang Ng, I. How Chen, Chien Yu Lin, Kang Hsing Fan, Joseph Tung Chieh Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

32 Scopus citations

Abstract

Objectives: To evaluate the prognostic value of maximum standardized uptake value (SUVmax) measured in [18F]-fluorodeoxyglucose positron emission tomography (18F-FDG PET) for patients with non-disseminated nasopharyngeal carcinoma (NPC). Materials and methods: From January 2002 to July 2008, 371 NPC patients who underwent 18F-FDG-PET before radical intensity-modulated radiotherapy (IMRT) were recruited. The SUVmax was recorded for the primary tumor (SUVmax-T) and neck lymph nodes (SUVmax-N). Results: The median follow-up was 64 months. The optimal cutoff value was 9.3 for SUVmax-T and 7.4 for SUVmax-N. Patients with a lower SUVmax-T or SUVmax-N had a significantly better 5-year distant metastasis-free survival (DMFS), but showed no significant difference in local control or regional control. Patients were divided into four groups by SUVmax, as follows: (a) both lower SUVmax-T and SUVmax-N, (b) higher SUVmax-T only, (c) higher SUVmax-N only, and d) both higher SUVmax-T and SUVmax-N. There were significant differences between these four groups in 5-year DMFS: (a) 95.5%, (b) 90.0%, (c) 83.3%, and (d) 79.9%, respectively (p = 0.004). When looking at the stage of disease, the 5-year DMFSs in group a, b, c, d were 96.9%, 94.6%, 97.4%, and 84.3%, respectively in stage I-III patients (p = 0.037) and were 91.6%, 82.9%, 68.5%, and 76.7% in stage IVA-B patients (p = 0.145). Using multivariate analysis, the SUVmax grouping, gender, and stage were independent factors for DMFS. Conclusion: The SUVmax of the primary tumor and neck lymph nodes were independent prognostic factors for DMFS in NPC patients treated with IMRT.

Original languageEnglish
Pages (from-to)169-174
Number of pages6
JournalOral Oncology
Volume49
Issue number2
DOIs
StatePublished - 02 2013

Keywords

  • Distant metastasis
  • F-fluorodeoxyglucose positron emission tomography
  • Intensity-modulated radiotherapy
  • Nasopharyngeal carcinoma
  • Prognosis

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