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Prognostic value of pre-treatment 18F-FDG PET uptake for nasopharyngeal carcinoma

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Abstract

Purpose

To evaluate the prognostic value of maximal standardized uptake values (SUVmax) from serial fluor-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with nasopharyngeal carcinoma (NPC).

Materials and methods

Fifty-two patients with NPC who underwent 18F-FDG PET/CT scan before radiotherapy with/without chemotherapy were reviewed retrospectively. Twenty-seven patients (52%) were applied 3-D conformal radiotherapy and 25 patients (48%) applied intensity-modulated radiotherapy (IMRT). Fourteen (27%) patients were given neoadjuvant chemotherapy and forty-four (84.6%) patients were given concomitant and adjuvant chemotherapy.

Results

Median follow-up time was 34 months (range 5.6–66.4 months). Forty-four (84.6%) patients were alive at last follow-up and eight (15.4%) had died. The best cut-off value of the SUVmax for the primary tumor site (SUVmax-PT) was 13 and 9 for the lymph nodes (SUVmax-LN). Patients with SUVmax-PT ≥ 13.0 and SUVmax-LN ≥ 9 had a significantly higher risk for the development of the distant metastases (p = 0.044 and p = 0.038). DFS was affected in patients with SUVmax-PT ≥ 13 (log rank χ 2 = 2.54, p = 0.017) and was significantly lower in patients with SUVmax-LN ≥ 9 for the lymph nodes (log rank χ 2 = 5.81, p = 0.013). OS was not affected by SUV levels. A multivariate Cox proportional hazard model of DFS included age (≥ 40), SUVmax-LN (< 9), T stage (T1–2) and neoadjuvant chemotherapy are significantly better prognosis for the DFS.

Conclusion

18F-FDG PET/CT uptake before treatment, as determined by SUVmax, may be a valuable tool to evaluate prognosis in NPC patients.

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Authors and Affiliations

  1. Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, 42090, Konya, Turkey

    Meryem Aktan, Gul Kanyilmaz, Berrin Benli Yavuz & Mehmet Koc

  2. Department of Otorhinolaryngology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

    Mehmet Akif Eryılmaz

  3. Department of Radiation Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey

    Mustafa Adli

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  1. Meryem Aktan
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Author Meryem AKTAN declares that she has no conflict of interest. Author Gul KANYILMAZ declares that she has no conflict of interest. Author Berrin BENLI YAVUZ declares that she has no conflict of interest. Author Mehmet KOC declares that he has no conflict of interest. Author Mehmet Akif ERYILMAZ declares that he has no conflict of interest. Author Mustafa ADLI declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Aktan, M., Kanyilmaz, G., Yavuz, B.B. et al. Prognostic value of pre-treatment 18F-FDG PET uptake for nasopharyngeal carcinoma. Radiol med (2017). https://doi.org/10.1007/s11547-017-0837-4

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