title: The role of pretreatment FDG-PET in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy.
abstract: OBJECTIVE
  Pretreatment with 2- [(18)F] fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) was evaluated as a predictor of local failure-free survival (LFFS), disease-free survival (DFS), and overall survival (OS) in patients with nonkeratinizing nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) alone or concurrently with chemotherapy (CCRT).
  
  
  METHODS
  Seventy-five M0 NPC patients who received FDG-PET before treatment were analyzed. The primary tumor FDG uptake was measured as the maximum standardized uptake value (SUVmax). The LFFS, DFS, and OS were calculated by the Kaplan-Meier method, and the differences were evaluated on log-rank test. The prognostic significance was assessed by univariate and multivariate analyses.
  
  
  RESULTS
  Eighteen patients received IMRT alone and 57 received CCRT. The mean SUVmax was significantly higher in 12 patients with locoregional or distant failure than in those without failure (p <0.001). On multivariate analysis, the SUVmax was the only significant variable for 5-year LFFS (p = 0.017) and DFS (p = 0.000) but not for OS (p = 0.065).
  
  
  CONCLUSIONS
  SUVmax is a potential independent prognostic predictor of clinical outcomes in patients with nasopharyngeal carcinoma treated with IMRT alone or with CCRT. A high (18)F-FDG uptake (SUVmax >5) indicates poor outcome in patients with NPC.
authors.affiliation: School of Medicine, Chung Shan Medical University and Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Wen-Shan
authors.initials: WS
authors.lastname: Liu
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Wu
authors.forename: Hsien-Chun
authors.initials: HC
authors.lastname: Tseng
authors.forename: Jung-Tung
authors.initials: JT
authors.lastname: Liu
authors.forename: Jui-Hung
authors.initials: JH
authors.lastname: Weng
authors.forename: Yueh-Chun
authors.initials: YC
authors.lastname: Li
authors.forename: Jong-Kang
authors.initials: JK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000378:metabolism*; D050397:Radiotherapy, Intensity-Modulated; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18