Primary vs nodal site PET/CT response as a prognostic marker in oropharyngeal squamous cell carcinoma treated with intensity‐modulated radiation therapy

Abstract

Background Positron emission tomography/computed tomography (PET/CT) in staging of advanced oropharyngeal squamous cell carcinoma (OPSCC) and at 3 months posttreatment (PETpost) is often utilized to assess response. The significance of lymph node vs primary site treatment response is incompletely understood. Methods We reviewed 230 patients treated with radiation therapy. PETpost response was graded at primary and nodal sites and correlated with survival. Results Median age was 58, and 83% were p16‐positive. Median follow‐up was 24.3 months. Nodal response at PETpost predicted improved 2‐year local recurrence‐free survival (LRFS) (93% vs 72%, P =.004), 2‐year disease‐free survival (DFS) (80% vs 61.3%, P =.021), and 2‐year overall survival (OS) (89% vs 83%, P =.051), while primary response only predicted improved 2‐year LRFS (91% vs 76% P = .035). Conclusion In OPSCC patients, both nodal and primary response at 3 months on PET/CT predicted for improved LRFS, but only nodal response predicted DFS and OS.

Hybrid positron emission tomography imaging for initial staging of sinonasal tumors: Total lesion glycolysis as prognosticator of treatment response

“…During the last decades, 18F‐fluoro‐deoxy‐ d ‐glucose (FDG) positron emission tomography (PET)/CT (FDG‐PET/CT) emerged as an alternative for the initial staging of sinonasal tumors, providing information on both metabolic activity and local extent of the primary tumor and on the presence of regional and distant metastases (DM). While various studies have investigated the diagnostic accuracy of FDG‐PET/CT in the staging and re‐staging of squamous cell carcinoma (SCC) of the upper aero‐digestive tract, only a few studies addressed its use for the initial staging of sinonasal tumors 9‐13 . Ozturk et al demonstrated that pretreatment diffusion‐weighted MRI in combination with FDG‐PET/CT parameters may serve as surrogate marker for the prognosis of sinonasal malignancies 14 .…”

“…While various studies have investigated the diagnostic accuracy of FDG-PET/CT in the staging and re-staging of squamous cell carcinoma (SCC) of the upper aerodigestive tract, only a few studies addressed its use for the initial staging of sinonasal tumors. [9][10][11][12][13] Ozturk et al demonstrated that pretreatment diffusion-weighted MRI in combination with FDG-PET/CT parameters may serve as surrogate marker for the prognosis of sinonasal malignancies. 14 Ramakrishnan et al reported a sensitivity of FDG-PET/CT of 94% for the diagnosis of sinonasal primaries, and a comparably high yield of regional metastases (27%) and DM (6%) in a cohort of 51 patients.…”

Whole‐body hybrid positron emission tomography imaging yields clinically relevant information in the staging and restaging of sinonasal tumors

“…In the last decades, 2‐[ 18 F]‐fluorodeoxy‐ d ‐glucose (FDG) positron emission tomography (PET)/CT (FDG‐PET/CT) and more recently FDG‐PET/MRI emerged as potential alternatives for the assessment of sinonasal tumors, providing information on both metabolic activity and local extent of the primary tumor and on the presence of regional and distant metastases (DM) 10,11 . While various studies have investigated the diagnostic accuracy of hybrid PET imaging for squamous cell carcinoma (SCC) of the upper aero‐digestive tract, only a few studies addressed its use for primary sinonasal malignancies 10,12–16 . In a recent study on the initial staging of sinonasal malignancies with hybrid PET, Meerwein et al reported an excellent sensitivity in detecting primary tumors, lymph node (LN) metastases, and DM and identified the PET parameter total lesion glycolysis (TLG) as an independent prognosticator of complete remission 10 .…”

“… 10 , 11 While various studies have investigated the diagnostic accuracy of hybrid PET imaging for squamous cell carcinoma (SCC) of the upper aero‐digestive tract, only a few studies addressed its use for primary sinonasal malignancies. 10 , 12 , 13 , 14 , 15 , 16 In a recent study on the initial staging of sinonasal malignancies with hybrid PET, Meerwein et al reported an excellent sensitivity in detecting primary tumors, lymph node (LN) metastases, and DM and identified the PET parameter total lesion glycolysis (TLG) as an independent prognosticator of complete remission. 10 Ozturk et al demonstrated that FDG‐PET/CT is an accurate diagnostic tool, providing a sensitivity of 81% and specificity of 99% for detection of DM, and 83% and 96% for LN metastases, respectively.…”