title: Prognostic value of 18F-FDG-PET/CT in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis.
abstract: BACKGROUND
  The prognostic role of 18F-fluorodeoxyglucose positron emission tomography CT (18F-FDG PET/CT) parameters is still controversial in nasopharyngeal carcinoma patients. We sought to perform a systematic review and meta-analysis to explore the prognostic value of maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on event-free survival (EFS) and overall survival (OS) in nasopharyngeal carcinoma patients.
  
  
  RESULTS
  Fifteen studies comprising 1,938 patients were included in this study. The combined hazard ratios (HRs) for EFS were 2.63 (95%CI 1.71-4.05) for SUVmax, 2.55 (95%CI 1.49-4.35) for MTV, and 3.32 (95%CI 1.23-8.95) for TLG. The pooled HRs for OS were 2.07 (95%CI 1.54-2.79) for SUVmax, 3.86 (95%CI 1.85-8.06) for MTV, and 2.60 (95%CI 1.55-4.34) for TLG. The prognostic role of SUVmax, MTV and TLG remained similar in the sub-group analyses.
  
  
  METHODS
  A systematic literature search was performed to identify studies which associated 18F-FDG PET/CT to clinical survival outcomes of nasopharyngeal carcinoma patients. The summarized HRs for EFS and OS were estimated by using fixed- or random-effect models according to heterogeneity between trials.
  
  
  CONCLUSIONS
  The present meta-analysis confirms that high values of SUVmax, MTV and TLG predicted a higher risk of adverse events or death in patients with nasopharyngeal carcinoma, despite clinically heterogeneous nasopharyngeal carcinoma patients and the various methods adopted between these studies.
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Guozhu
authors.initials: G
authors.lastname: Xie
authors.affiliation: Department of Radiation Oncology, Shenzhen people's Hospital, Second Clinical Medicine College of Jinan University, China.
authors.forename: Guixiang
authors.initials: G
authors.lastname: Liao
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Baiyao
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Miaohong
authors.initials: M
authors.lastname: Yan
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.|Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Yawei
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000401:mortality*; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D017594:Publication Bias; D012372:ROC Curve
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG PET/CT; metabolic tumor volume; nasopharyngeal carcinoma; standardized uptake value; total lesion glycolysis