Measurement of tumor volume by PET to evaluate prognosis in patients with head and neck cancer treated by chemo-radiation therapy.
OBJECTIVE
To evaluate the prognostic value of the metabolic tumor volume measured on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging and other clinical factors in patients treated for locally advanced head-and-neck cancer (HNC) at a single institution.


METHODS
Between June 2005 and August 2008, 59 patients with HNC that underwent pretreatment FDG-PET studies received neoadjuvant chemotherapy and radiation therapy. Metabolically active tumor regions were delineated on the pretreatment PET scans by a fixed SUV of 2.5. We evaluated the relationship of the 18F-fluorodeoxyglucose-PET maximum standardized uptake value (SUV) and the metabolic tumor volume (MTV) with the progression-free survival (PFS) and overall survival (OS).


RESULTS
The MTV and lymph node metastasis were predictive of the PFS and OS. The lymph node status did not correlate with the MTV. A higher MTV of 9.3 cm(3) was significantly associated with an increased risk of recurrence (2.19-fold, p = 0.006) and death (1.62-fold, p = 0.051). Separation of patients with tumor volumes <or= 9.3 cm(3) and no lymph node disease vs. any other combination was strongly predictive of the PFS and the OS.


CONCLUSIONS
MTV and lymph node status were prognostic values associated with survival. Quantitative measurement of tumor volume separates patients with a good prognosis from those with a poorer prognosis. A subset of patients with relatively small tumors and no lymph node involvement did very well.
Seol
Young Mi
YM
Division of Hemato-oncology, Department of Internal Medicine, National University Hospital Medical Research Institute, Seo-Gu, Busan, Korea.
Kwon
Bo Ran
BR
Song
Moo Kon
MK
Choi
Young Jin
YJ
Shin
Ho Jin
HJ
Chung
Joo Seop
JS
Cho
Goon Jae
GJ
Lee
Jin Chun
JC
Lee
Byung Joo
BJ
Wang
Soo Geun
SG
Kim
Hak Jin
HJ
Kim
Won Taek
WT
Kim
Seung Jang
SJ
Yun
Eun Young
EY
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D011878:Radiotherapy; D012189:Retrospective Studies; D047368:Tumor Burden / Q000187:drug effects / Q000528:radiation effects
D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18