Prognostic significance of 18F-FDG PET parameters and plasma Epstein-Barr virus DNA load in patients with nasopharyngeal carcinoma.
The plasma concentration of Epstein-Barr virus (EBV) DNA is associated with tumor burden and prognosis in patients with nasopharyngeal carcinoma (NPC), but data on the relationship between viral load and (18)F-FDG PET functional parameters are lacking. We examined the association of (18)F-FDG PET functional parameters and EBV DNA load with the clinicopathologic characteristics and clinical outcomes of patients with NPC.


METHODS
One hundred eight patients with NPC who underwent (18)F-FDG PET before treatment were included in this study. We determined total lesion glycolysis (TLG) of the primary tumor, the cervical nodes, and their combination and the maximal standardized uptake value of the primary tumor and cervical lymph nodes. EBV DNA was measured by real-time polymerase chain reaction.


RESULTS
EBV DNA was significantly associated with total TLG (R(2) = 0.589). Total TLG values had the highest correlation with EBV DNA load and were significantly associated with tumor, nodal, and overall stages. However, tumor TLG greater than the median (>65 g) was the only parameter significantly associated with overall, local recurrence-free, disease-free, and distant metastasis-free survivals (P = 0.033, 0.014, <0.001, and 0.023, respectively). After allowance for potential confounders, tumor TLG retained its independent significance for overall and disease-free survival rates (P = 0.045 and 0.006, respectively).


CONCLUSIONS
Total TLG values are primarily associated with tumor burden and clinical stage, whereas tumor TLG is the best predictor of patient survival after treatment.
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taipei, Taiwan. changkp@cgmh.org.tw
Kai-Ping
KP
Chang
Ngan-Ming
NM
Tsang
Chun-Ta
CT
Liao
Cheng-Lung
CL
Hsu
Ming-Jui
MJ
Chung
Chuan-Wei
CW
Lo
Sheng-Chieh
SC
Chan
Shu-Hang
SH
Ng
Hung-Ming
HM
Wang
Tzu-Chen
TC
Yen
D014408:Biomarkers, Tumor / Q000097:blood; D002277:Carcinoma; D004279:DNA, Viral / Q000097:blood*; D019788:Fluorodeoxyglucose F18; D004854:Herpesvirus 4, Human / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D016896:Treatment Outcome; D019562:Viral Load
D014408:Biomarkers, Tumor; D004279:DNA, Viral; D019788:Fluorodeoxyglucose F18