Post-radiotherapy PET/CT for predicting treatment outcomes in head and neck cancer after postoperative radiotherapy.
Purpose: The purpose of this study was to retrospectively review the role of post-treatment (post-tx) FDG-PET/CT scans in patients receiving postoperative intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinomas (HNSCC). Materials and methods: Eighty-two patients with HNSCC...
| Published in: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 46; no. 4; pp. 794 - 801 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Published: |
Springer Nature
Apr2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135780311&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135780311 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: Apr2019 vid: 46 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 135780311 10.1007/s00259-019-4272-8 135780311 ppf: 794 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Post-radiotherapy PET/CT for predicting treatment outcomes in head and neck cancer after postoperative radiotherapy. aug: au: Li, Yan Chen, Nianyong Awan, Musaddiq J. Chang, Tangel Lavertu, Pierre Zender, Chad Rezaee, Rod Fowler, Nicole Wasman, Jay Avril, Norbert E. Machtay, Mitchell Yao, Min affil: Department of Radiation Oncology, West China Hospital of Sichuan University, Chengdu, China sug: ab: Purpose: The purpose of this study was to retrospectively review the role of post-treatment (post-tx) FDG-PET/CT scans in patients receiving postoperative intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinomas (HNSCC). Materials and methods: Eighty-two patients with HNSCC treated with surgery and postoperative IMRT with or without chemotherapy from October 15, 2008 to December 31, 2014 that had post-tx PET/CT within 6 months of completing IMRT were included. PET/CT was considered positive based on multi-disciplinary review integrating clinical information. Survival analysis was performed using the Kaplan-Meier method. Categorical and continuous predictors of positive post-tx PET/CT were evaluated using Fisher's exact test and logistic regression, respectively. Predictors for survival outcomes were evaluated with log-rank testing. A p ≤ 0.05 was considered statistically significant. Results: Median follow-up was 3.88 years. For all patients, 3-year overall survival (OS) and recurrence-free survival (RFS) were 71.8% and 61.3%, respectively. Patients with positive post-tx PET/CT had worse OS compared to those with negative post-tx PET/CT (log rank p < 0.001). For patients with positive post-tx PET/CT, 3-year OS was 11.2% compared to 89.9% for patients with negative post-tx PET/CT. The positive predictive value (PPV) of PET/CT was 100% for local recurrence (LR), regional recurrence (RR) and distant metastasis (DM). The negative predictive values (NPV) for LR, RR and DM were 89.0%, 89.2%, and 85.9%, respectively. Perineural invasion (p = 0.009), p16 status (p = 0.009), non-oropharyngeal primary site (p = 0.002), and the use of chemotherapy (p = 0.01) were independent predictors of positive PET/CT. Conclusions: Post-tx PET/CT after postoperative radiation is prognostic for survival outcomes. The PPV of post-tx PET for recurrence was excellent, allowing for early detection of recurrent disease. Post-tx PET/CT should be considered after postoperative radiation. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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