18F-FDG-PET for evaluation of the response to concurrent chemoradiation therapy with intensity-modulated radiation technique for Stage T4 nasopharyngeal carcinoma

Tzu Chen Yen, Chien Yu Lin, Hung Ming Wang, Shiang Fu Huang, Chun Ta Liao, Chung Jan Kang, Shu Hang Ng, Sheng Chieh Chan, Kang Hsing Fan, I. How Chen, Wuu Jyh Lin, Ann Joy Cheng, Joseph Tung Chieh Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

38 Scopus citations

Abstract

Purpose: This article evaluates [18F] fluorodeoxyglucose positron emission tomography (18F-FDG-PET) findings as a predictor for local responders (R) vs. nonresponders (NR) in nasopharyngeal carcinoma (NPC) patients with Stage T4 lesions, before and at 3 months after completion of concurrent chemotherapy and radiation therapy (CCRT). Methods and Materials: From January 2002 to November 2003, 39 T4 NPC patients were enrolled. All had magnetic resonance imaging and 18F-FDG-PET, both before and 3 months after CCRT. Any residual/recurrent lesions were confirmed histopathologically. Results: Of the 39 eligible patients, after a follow-up of 24.2 ± 9.5 months, 35 became disease-free and 4 had residual or recurrent disease. Marginal differences in standard uptake values (SUV) were observed (10.9 ± 5.3 vs. 15.6 ± 3.4, p = 0.058) between R and NR before treatment, and value changes of SUV before and after CCRT were not significantly different. However, highly significantly lower values of SUV were noted for R than for NR 3 months after completion of CCRT (2.1 ± 0.8 vs. 5.5 ± 3.2, p = 0.001). One hundred percent positive and negative predictive values were observed for SUV values of 4.0, set 3 months after completion of CCRT. Conclusions: Neither the pretreatment SUV nor the changes of SUV between pretreatment and posttreatment were significant predictors for local response. SUV at 3 months after completion of CCRT was a significant determinator for local response. The cutoff of 4.0 for SUV at 3 months after completion of CCRT was useful to be offered as a diagnostic reference for recurrent or residual tumor for NPC treatment.

Original languageEnglish
Pages (from-to)1307-1314
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume65
Issue number5
DOIs
StatePublished - 01 08 2006
Externally publishedYes

Keywords

  • Concurrent chemotherapy and radiation therapy
  • F-FDG-PET
  • Nasopharyngeal carcinoma
  • Response

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