title: Volumetric PET/CT parameters predict local response of head and neck squamous cell carcinoma to chemoradiotherapy.
abstract: It is not well established whether pretreatment (18) F-FDG PET/CT can predict local response of head and neck squamous cell carcinoma (HNSCC) to chemoradiotherapy (CRT). We examined 118 patients: 11 with nasopharyngeal cancer (NPC), 30 with oropharyngeal cancer (OPC), and 77 with laryngohypopharyngeal cancer (LHC) who had completed CRT. PET/CT parameters of primary tumor, including metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum and mean standardized uptake value (SUVmax and SUVmean ), were correlated with local response, according to primary site and human papillomavirus (HPV) status. Receiver-operating characteristic analyses were made to access predictive values of the PET/CT parameters, while logistic regression analyses were used to identify independent predictors. Area under the curve (AUC) of the PET/CT parameters ranged from 0.53 to 0.63 in NPC and from 0.50 to 0.54 in OPC. HPV-negative OPC showed AUC ranging from 0.51 to 0.58, while all of HPV-positive OPCs showed complete response. In contrast, AUC ranged from 0.71 to 0.90 in LHC. Moreover, AUCs of MTV and TLG were significantly higher than those of SUVmax and SUVmean (P < 0.01). After multivariate analysis, high MTV >25.0 mL and high TLG >144.8 g remained as independent, significant predictors of incomplete response compared with low MTV (odds ratio [OR], 13.4; 95% confidence interval [CI], 2.5-72.9; P = 0.003) and low TLG (OR, 12.8; 95% CI, 2.4-67.9; P = 0.003), respectively. In conclusion, predictive efficacy of pretreatment (18) F-FDG PET/CT varies with different primary sites and chosen parameters. Local response of LHC is highly predictable by volume-based PET/CT parameters.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hanamoto
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Tatsumi
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Takenaka
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yasui
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakahara
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Seo
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016017:Odds Ratio; D049268:Positron-Emission Tomography; D012372:ROC Curve; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Chemoradiotherapy; head and neck squamous cell carcinoma; local response; metabolic tumor volume; total lesion glycolysis