Metabolic tumor volume of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography predicts short-term outcome to radiotherapy with or without chemotherapy in pharyngeal cancer.
OBJECTIVE
This study aimed to investigate whether metabolic tumor volume (MTV) measured from [(18)F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) predicts short-term outcome to radiotherapy with or without chemotherapy and disease-free survival (DFS) in patients with pharyngeal cancers.


METHODS
The MTVs of primary sites with or without neck nodes were measured in 82 patients. Short-term outcome was assessed using the treatment response evaluation by the Response Evaluation Criteria in Solid Tumors and recurrence events during follow-up (complete response/no recurrence or residual disease/recurrence).


RESULTS
A total of 64 patients had complete response/no recurrence as of the last follow-up. A cutoff of 40 mL for the MTV was the best discriminative value for predicting treatment response. By univariate analyses, patients with MTV > 40 mL showed a significantly lower number of complete response/no recurrence than did patients with MTV < or =40 mL [68.2% versus 87.8%; hazard ratio (HR), 3.34; 95% confidence interval (95% CI), 1.09-10.08; P = 0.03], as is the same in tumor-node-metastasis stage (87.5% for I-II versus 90% for III versus 63.8% for IV; P = 0.02). However, MTV was only a significant predictor of short-term outcome by multivariate analyses (HR, 4.09; 95% CI, 1.02-16.43; P = 0.04). MTV > 40 mL indicated a significantly worse DFS than MTV < or =40 mL (HR, 3.42; 95% CI, 1.04-11.26;P = 0.04). The standardized uptake value for the primary tumor did not show any correlation with treatment outcome or DFS.


CONCLUSIONS
MTV has a potential value in predicting short-term outcome and DFS in patients with pharyngeal cancers.
Chung
Man Ki
MK
Departments of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jeong
Han-Sin
HS
Park
Sang Gyu
SG
Jang
Jeon Yeob
JY
Son
Young-Ik
YI
Choi
Joon Young
JY
Hyun
Seung Hyup
SH
Park
Keunchil
K
Ahn
Myung-Ju
MJ
Ahn
Yong Chan
YC
Kim
Hyung-Jin
HJ
Ko
Young-Hyeh
YH
Baek
Chung-Hwan
CH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
D019788:Fluorodeoxyglucose F18