Authors: Maria Hentschel Steffen Appold Andreas Schreiber Nasreddin Abolmaali Andrij Abramyuk Wolfgang Dörr Joerg Kotzerke Michael Baumann Klaus Zöphel
Publish Date: 2011/02/25
Volume: 38, Issue: 7, Pages: 1203-1211
Abstract
Our study aimed to explore the optimal timing as well as the most appropriate prognostic parameter of 18Ffluorodeoxyglucose positron emission tomography FDG PET during chemoradiotherapy CRT for an early prediction of outcome for patients with head and neck squamous cell carcinoma HNSCCSerial PET data before and three times during CRT of 37 patients with advanced stage HNSCC receiving combined CRT between 2005 and 2009 were evaluated The maximum standardized uptake value SUVmax the average SUV SUVmean and the gross tumour volume determined by FDG PET GTV PET based on a source to background algorithm were analysed Stratified actuarial analysis was performed for overall survival OS diseasefree survival DFS and locoregional control LRC The median followup time was 26 months range 8–50For all patients OS was 51 DFS 44 and LRC 55 after 2 years The 2year OS 88 and 2year LRC 88 were higher for patients whose SUVmax of the primary tumour decreased 50 or more from the beginning 0 Gy to week 1 or 2 10 or 20 Gy of CRT ΔSUVmax10/20 ≥ 50 than for patients with ΔSUVmax20 50 2year OS = 38 p = 002 2year LRC 40 p = 006 A pretreatment GTV PET below the median of 102 ml predicted a better 2year OS 34 for GTV PET ≥ 102 ml vs 83 for GTV PET 102 ml p = 002The decrease of SUVmax from before 0 Gy to week 1 or 2 10 or 20 Gy of CRT is a potential prognostic marker for patients with HNSCC Because GTV PET depends on the applied method of analysis we suggest the use of SUVmax especially ΔSUVmax10/20 for an early estimation of therapy outcome Confirmatory studies are warranted
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