title: [18F]-Fluorodeoxyglucose Positron Emission Tomography Standardized Uptake Value as a Predictor of Adjuvant Chemotherapy Benefits in Patients With Nasopharyngeal Carcinoma.
abstract: BACKGROUND
  The role of adjuvant chemotherapy for the treatment of nasopharyngeal carcinoma (NPC) is controversial, and the identification of adequate predictive factors is warranted. Therefore, we aimed to investigate whether the mean standardized uptake value (SUV) measured on [(18)F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) could predict the survival benefits for NPC patients that receive adjuvant chemotherapy.
  
  
  METHODS
  The data for 174 NPC patients who underwent PET/computed tomography before chemoradiation between January 2004 and January 2012 were reviewed. The SUV75% was recorded for primary tumors. All patients received intensity-modulated radiotherapy and cisplatin-based chemotherapy. Adjuvant chemotherapy consisted of 3 cycles of 75 mg/m(2) cisplatin and 1,000 mg/m(2) fluorouracil for 4 days.
  
  
  RESULTS
  The optimal cutoff value was 8.35 for SUV75%, with 112 (64.4%) patients having lower SUV75% and 62 (35.6%) having higher SUV75%. Patients with lower SUV75% had significantly better 5-year overall survival (OS) and distant metastasis-free survival. Multivariate analysis revealed that tumor stage, SUV75%, and adjuvant chemotherapy were significant prognostic factors for OS. Patients with higher SUV75% had significantly higher 5-year OS rates with adjuvant chemotherapy than without adjuvant chemotherapy (84.3% vs. 32.4%, respectively; p < .001). However, in the lower SUV75% group, no differences in 5-year OS were observed between patients who received and those who did not receive adjuvant chemotherapy (92.4% vs. 93.3%, respectively; p = .682).
  
  
  CONCLUSIONS
  The SUV75% on FDG PET for primary tumors could successfully identify NPC patients who may benefit from adjuvant chemotherapy.
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Te-Chun
authors: TC
authors: Hsieh
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Ching Yun
authors: CY
authors: Hsieh
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Tse Yen
authors: TY
authors: Yang
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Tzu Ting
authors: TT
authors: Chen
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Chen Yuan
authors: CY
authors: Lin
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China linchin13256@gmail.com.
authors: Ching-Chan
authors: CC
authors: Lin
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Chung Hung
authors: CH
authors: Hua
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Chang-Fang
authors: CF
authors: Chiu
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Su-Peng
authors: SP
authors: Yeh
authors: Department of Nuclear Medicine, Department of Biomedical Imaging and Radiological Science, School of Medicine, Department of Internal Medicine, Division of Hematology and Oncology, Molecular and Genomic Epidemiology Center, and Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Yuh Pyng
authors: YP
authors: Sher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D011859:Radiography; D015996:Survival Rate
chemical_list: D019788:Fluorodeoxyglucose F18; D002945:Cisplatin; D005472:Fluorouracil
keywords: Adjuvant; Chemotherapy; Nasopharyngeal neoplasms; Positron emission tomography; Radiotherapy