[18F]-FDG PET-CT prediction of response to induction chemotherapy in head and neck squamous cell carcinoma: Preliminary findings

Gavid, M.; Prévôt-Bitot, Nathalie; Timoschenko, A.; Gallet, P.; Martin, C.; Prades, Jean-Michel

doi:10.1016/j.anorl.2014.01.009

Cited by 19 publications

(33 citation statements)

References 24 publications

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“…Three studies have evaluated response assessment with 18 F-FDG PET/CT after IC1 in HNSCC (21-23). However, none was designed to inform how best to personalize treatment based on response: one only investigated the correlation between PET parameters after IC1 and endoscopic response after IC before definitive treatment (22), and the other 2 had large variations in both the scanning timeline (anytime 2-4 wk after IC1) and the (A) Dot-plot of DTLG 40% after IC1 with suggested receiver-operator curve coordinates (−30%, −60%, and −82%) as cut-offs for predicting complete response to chemoradiotherapy. Optimal sensitivity and specificity achieved by DTLG 40% after IC1 as a standalone parameter were 73% and 80%, respectively (−60%).…”

Section: Discussionmentioning

confidence: 99%

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with ¹⁸F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

et al. 2016

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The objective of this study was to assess the predictive value of early assessment (after 1 cycle of induction chemotherapy [IC]) with 18 F-FDG PET/CT and diffusion-weighted (DW) MRI for subsequent response to radical chemoradiotherapy in locally advanced head and neck squamous cell carcinoma (HNSCC). Methods: Twenty patients with stage III-IVa HNSCC prospectively underwent 18 F-FDG PET/CT and DW MRI before and 2 wk after each cycle of IC (first cycle, IC1; second cycle, IC2). Response was assessed 3 mo after completion of chemoradiotherapy with clinical examination, MRI, and 18 F-FDG PET/CT. Patients with persistent disease were classed as nonresponders. Changes in functional and molecular imaging parameters after IC1 were compared between responders and nonresponders with the Mann-Whitney U test. The significance threshold was set at a P value of less than 0.05. Results: Responders showed a significantly greater reduction in metabolic tumor volume (P 5 0.03) and total lesion glycolysis (P 5 0.04) after IC1 than nonresponders. Responders also showed a tendency toward a larger but statistically nonsignificant increase in apparent diffusion coefficient after IC1. There was no significant difference in the changes from baseline between the IC1 and IC2 for all functional and molecular imaging parameters, indicating that most biologic response to IC measured by 18 F-FDG PET/CT and DW MRI was observed early after the first cycle of IC. Conclusion: Our preliminary data indicate that the 18 F-FDG PET/CT-derived metabolic tumor volume or total lesion glycolysis, acquired after IC1, are early predictive biomarkers for ultimate response to subsequent chemoradiotherapy. These early biomarkers enable identification of patients at risk of treatment failure at an early time point, permitting treatment individualization and consideration of alternative strategies such as radiotherapy dose escalation or surgery.

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Section: Discussionmentioning

confidence: 99%

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with ¹⁸F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

et al. 2016

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“…18 F-Fluoro-deoxy-glucose positron emission tomography ( 18 F-FDG-PET) has been applied in assessing the treatment response for NPC [4] and other tumors such as head and neck squamous cell carcinoma (HNSCC), [5,6] rectal cancer, [7] and breast cancer. [8] However, the complex anatomy of nasopharynx, low spatial resolution, and treatment-induced inflammation may decrease the accuracy of 18 F-FDG-PET.…”

Section: Introductionmentioning

confidence: 99%

Value of intravoxel incoherent motion and dynamic contrast-enhanced MRI for predicting the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma

Hou

Xiao-ping

et al. 2016

Medicine

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The aim of the study was to investigate the value of intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the early and short-term responses to chemoradiotherapy (CRT) in patients with nasopharyngeal carcinoma (NPC).Forty-three NPC patients underwent IVIM-DWI and DCE-MRI at baseline (pretreatment) and after the first cycle of induction chemotherapy (posttreatment). Based on whether locoregional lesions were identified, patients were divided into the residual and nonresidual groups at the end of CRT and into the good-responder and poor-responder groups 6 months after the end of CRT. The pretreatment and posttreatment IVIM-DWI parameters (ADC, D, D∗, and f) and DCE-MRI parameters (Ktrans, Kep, and Ve) values and their percentage changes (Δ%) were compared between the residual and nonresidual groups and between the good-responder and poor-responder groups.None of perfusion-related parametric values derived from either DCE-MRI or IVIM-DWI showed significant differences either between the residual and nonresidual groups or between the good-responder and poor-responder groups. The nonresidual group exhibited lower pre-ADC, lower pre-D, and higher Δ%D values than did the residual group (all P <0.05). The good-responder group had lower pre-D and pre-ADC values than did the poor-responder group (both P <0.05). Based on receiver operating characteristic (ROC) curve analysis, pre-D had the highest area under the curve in predicting both the early and short-term responses to CRT for NPC patients (0.817 and 0.854, respectively).IVIM-DWI is more valuable than DCE-MRI in predicting the early and short-term response to CRT for NPC, and furthermore diffusion-related IVIM-DWI parameters (pre-ADC, pre-D, and Δ%D) are more powerful than perfusion-related parameters derived from both IVIM-DWI and DCE-MRI.

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“…The limited number of patients in this study, coupled with the generally favorable PET responses to induction chemotherapy, precluded our ability to detect a correlation between PET changes and long-term oncologic outcomes. In contrast, several prior studies showed that post-induction FDG-PET responses correlated with subsequent PET responses and PFS [28][29][30]. The utility of FLT-PET in assessing responses after induction chemotherapy in HNSCC has only been evaluated by a small number of studies.…”

Section: Discussionmentioning

confidence: 94%

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

RS¹,

Vj²,

Rl³

et al. 2017

J Nucl Med Radiat Ther

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Objective: We prospectively compared FDG-PET and FLT-PET in assessing patient responses to induction cetuximab and/or chemoradiotherapy (CRT) for advanced head and neck squamous cell carcinoma (HNSCC) and esophageal cancer (EC). Methods:Sixteen patients were enrolled, 9 with HNSCC and 7 with EC. FDG-PET and FLT-PET scans were performed at baseline and two weeks into chemoradiotherapy (CRT) for patients with EC. Patients with HNSCC received two weeks of induction chemotherapy along with post-induction PET scans prior to starting CRT in addition to the baseline and intra-chemoradiotherapy PET scans. Changes in SUVmax and total lesion glycolysis/ proliferation (TLG/TLP) were compared with baseline.Results: Median follow-up for living patients was 6.0 years. Median overall survival (OS) was 3.3 years and progression-free survival (PFS) was 2.5 years. Patients with HNSCC had higher baseline SUVmax, TLG and TLP than those with EC. Changes in SUVmax, TLG and TLP after induction chemotherapy or during CRT did not correlate with PFS or OS. Those with >40% decline in SUVmax on FDG-PET six weeks after completing CRT had better PFS (p<0.0001) and OS (p=0.0003) than those with less of a response. In addition, >70% decrease in posttreatment TLG correlated with better PFS (p=0.03) and OS (p=0.04). Conclusions:Functional imaging performed early during chemoradiotherapy for advanced HNSCC and EC is feasible. Changes on post-induction and intra-CRT FLT and FDG PET did not correlate with PFS or OS. However, better PFS and OS were seen in patients with >40% decline in SUVmax and >70% decrease in TLG on FDG-PET performed six weeks after completing CRT. Further research is needed to determine the prognostic impact of PET performed during chemotherapy and radiotherapy.

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[18F]-FDG PET-CT prediction of response to induction chemotherapy in head and neck squamous cell carcinoma: Preliminary findings

Cited by 19 publications

References 24 publications

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with ¹⁸F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with ¹⁸F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

Value of intravoxel incoherent motion and dynamic contrast-enhanced MRI for predicting the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

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[18F]-FDG PET-CT prediction of response to induction chemotherapy in head and neck squamous cell carcinoma: Preliminary findings

Cited by 19 publications

References 24 publications

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with 18F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with 18F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

Value of intravoxel incoherent motion and dynamic contrast-enhanced MRI for predicting the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma

Long-term Results of a Pilot Study Comparing FLT-PET and FDG-PET in the Evaluation of Response to Treatment in Advanced Head and Neck and Esophageal Malignancies

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The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with ¹⁸F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma

The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with ¹⁸F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma