title: Measurement of tumor volume by PET to evaluate prognosis in patients with head and neck cancer treated by chemo-radiation therapy.
abstract: 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.
authors.affiliation: Division of Hemato-oncology, Department of Internal Medicine, National University Hospital Medical Research Institute, Seo-Gu, Busan, Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Seol
authors.forename: Bo Ran
authors.initials: BR
authors.lastname: Kwon
authors.forename: Moo Kon
authors.initials: MK
authors.lastname: Song
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Ho Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Chung
authors.forename: Goon Jae
authors.initials: GJ
authors.lastname: Cho
authors.forename: Jin Chun
authors.initials: JC
authors.lastname: Lee
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Lee
authors.forename: Soo Geun
authors.initials: SG
authors.lastname: Wang
authors.forename: Hak Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Won Taek
authors.initials: WT
authors.lastname: Kim
authors.forename: Seung Jang
authors.initials: SJ
authors.lastname: Kim
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Yun
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18