Prognostic utility of 18F-FDG PET-CT performed prior to and during primary radiotherapy for nasopharyngeal carcinoma: Index node is a useful prognostic imaging biomarker site

Lin, Peter; Min, Myo; Lee, Mark; Holloway, Lois; Forstner, Dion; Bray, Victoria; Xuan, Wei; Chicco, Andrew; Fowler, Allan

doi:10.1016/j.radonc.2016.05.021

Cited by 31 publications

(24 citation statements)

References 23 publications

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“…Five studies measured all the desired parameters (SUVmax, MTV, and TLG). [16,21–24] While there was 1 study that measured SUVmax and TLG [9] , 2 others reported SUVmax and MTV. [11,13] There were 5 studies that measured only SUVmax, [4,8,10,14,25] and 1 that reported only MTV.…”

Section: Resultsmentioning

confidence: 99%

“…[10,18] However, other studies included in our analysis used a fixed cutoff value (3.0) or expressed SUVmax as a percentage value (75%) to define VOI. [11,24] It is well known that the method used to determine the MTV or TLG of a tumor has an impact on the absolute value of the parameter, for the same tumor. In this study, subgroup analysis showed that studies defining MTV and TLG with a fixed SUV cutoff of 2.5 reported a 2.67 and 3.55-fold-higher risk of adverse events, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients

Huang¹,

Feng²,

et al. 2017

Medicine

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Background:Nasopharyngeal carcinoma (NPC) is a special subtype of head and neck cancer (HNC). At present, there are no highly specific prognostic markers to aid in tumor grading and guide patient treatment modalities for NPC. The prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-PET-CT) in NPC patients is controversial and no consensus exists as to its predictive capability.Methods:To analyze the predictive efficacy of 18F-PET-CT imaging in NPC patients, data from MEDLINE, EMBASE, the Cochrane library, CBM, CNKI, and VIP (inception to July 2016) were accessed. Results from prospective and retrospective observational studies that used 18F-FDG PET to predict disease prognosis in NPC patients were used for analysis. Two authors independently assessed study quality and extracted data. Event-free survival (EFS) was considered the primary endpoint and overall survival rate (OS) was considered the secondary endpoint.Results:Data from 14 studies and 1134 patients were included in our analysis. The hazard ratios (HRs) of maximum standardized uptake value of primary tumor (SUVmax-T), metabolic tumor volume of primary tumor (MTV-T), and total lesional glycolysis of primary tumor (TLG-T) for EFS were 1.31 (95% confidence interval [CI], 1.11–1.55, P = .001), 2.38 (95% CI 1.53–3.70, P < .001), and 1.65 (95% CI 0.76–3.59, P = .21), respectively. Among studies including TLG-T, those with a fixed SUV of 2.5 had an HR of 3.55 (95% CI, 1.42–8.84, P = .007). The HRs of SUVmax-T and MTV-T for OS were 2.19 (95% CI, 1.47–3.27, P < .001) and 2.69 (95% CI, 1.01–7.17, P = .05), respectively. Among studies including MTV-T, those with a fixed SUV of 2.5 had an HR of 4.07 (95% CI, 2.22–7.46, P < .001). Tests used for assessing predictive value of pretreatment SUVmax, MTV, and TLG of lymph nodes for EFS and OS showed that these parameters did not have significant predictive value (P>.05).Conclusion:Our results suggested that SUVmax, MTV, and TLG (with a fixed SUV of 2.5) of primary tumors before treatment initiation may be independent prognostic factors for NPC patients; however, SUVmax, MTV, and TLG of metastatic lymph nodes are not.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients

Huang¹,

Feng²,

et al. 2017

Medicine

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“…[9,10,17,18] Chang et al have reported that neither SUVmax nor TLG of metastatic LNs is a reliable predictor of OS in NPC patients, while Lin et al demonstrated that patients with a high SUVmax, TLG, and MTV of LNs have a worse OS prognosis. [12,24] In this context, we comprehensively evaluated the prognostic value of these PET-CT parameters in NPC patients. The results of our meta-analysis suggest that there is no significant correlation between pretreatment SUVmax, MTV, TLG status of metastatic LNs and disease prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Chan SC [12] 2011 China/Taiwan Chan SC [13] 2012 China/Taiwan . [16,[21][22][23][24] While there was 1 study that measured SUVmax and TLG [9] , 2 others reported SUVmax and MTV. [11,13] There were 5 studies that measured only SUVmax, [4,8,10,14,25] and 1 that reported only MTV.…”

Section: Study Selection and Characteristics Of Studiesmentioning

confidence: 99%

Prognostic value of pretreatment ¹⁸F-FDG PET-CT for nasopharyngeal carcinoma patients.

Huang

Feng

et al. 2017

JCO

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Background: Nasopharyngeal carcinoma (NPC) is a special subtype of head and neck cancer (HNC). At present, there are no highly specific prognostic markers to aid in tumor grading and guide patient treatment modalities for NPC. The prognostic value of pretreatment 18 F-fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-PET-CT) in NPC patients is controversial and no consensus exists as to its predictive capability.Methods: To analyze the predictive efficacy of 18 F-PET-CT imaging in NPC patients, data from MEDLINE, EMBASE, the Cochrane library, CBM, CNKI, and VIP (inception to July 2016) were accessed. Results from prospective and retrospective observational studies that used 18 F-FDG PET to predict disease prognosis in NPC patients were used for analysis. Two authors independently assessed study quality and extracted data. Event-free survival (EFS) was considered the primary endpoint and overall survival rate (OS) was considered the secondary endpoint.Results: Data from 14 studies and 1134 patients were included in our analysis. The hazard ratios (HRs) of maximum standardized uptake value of primary tumor (SUVmax-T), metabolic tumor volume of primary tumor (MTV-T), and total lesional glycolysis of primary tumor (TLG-T) for EFS were 1.31 (95% confidence interval [CI], 1.11-1.55, P = .001), 2.38 (95% CI 1.53-3.70, P < .001), and 1.65 (95% CI 0.76-3.59, P = .21), respectively. Among studies including TLG-T, those with a fixed SUV of 2.5 had an HR of 3.55 (95% CI, 1.42-8.84, P = .007). The HRs of SUVmax-T and MTV-T for OS were 2.19 (95% CI, 1.47-3.27, P < .001) and 2.69 (95% CI, 1.01-7.17, P = .05), respectively. Among studies including MTV-T, those with a fixed SUV of 2.5 had an HR of 4.07 (95% CI, 2.22-7.46, P < .001). Tests used for assessing predictive value of pretreatment SUVmax, MTV, and TLG of lymph nodes for EFS and OS showed that these parameters did not have significant predictive value (P>.05). Conclusion:Our results suggested that SUVmax, MTV, and TLG (with a fixed SUV of 2.5) of primary tumors before treatment initiation may be independent prognostic factors for NPC patients; however, SUVmax, MTV, and TLG of metastatic lymph nodes are not. Abbreviations:18 F-FDG PET = 18 F-fluorodeoxyglucose positron emission tomography, CI = confidence interval, CT = computed tomography, DFS = disease-free survival, DMFS = distant metastasis-free survival, EFS = event-free survival, HNC = head and neck cancer, HNSCC = head and neck squamous cell carcinoma, HR = hazard ratio, LN = lymph node, MTV = metabolic tumor volume, MTV-LN = metabolic-tumor-volume of lymph node, MTV-T = metabolic tumor volume of primary tumor, NPC = nasopharyngeal carcinoma, OS = overall survival, ROC = receiver operating characteristic curve, SUVmax = maximum standardized uptake value, SUVmax-LN = maximum standardized uptake value of LN, SUVmax-T = maximum standardized uptake value of primary tumor, TLG = total lesional glycolysis, TLG-LN = total lesional glycolysis of lymph node, TLG-T = total lesional glycolysis...

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“…In contrast, Guo et al (7) found that the maximal lymph nodal diameter measured in all the longitudinal, sagittal, and coronal planes was not a useful indicator in predicting the spread potential of NPC patients. It was suggested that the maximal lymph nodal diameter might not represent the tumor burden, which could be replaced by the tumor volume (15,16) and metabolic tumor volume (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Maximal lymph nodal diameter in staging system of nasopharyngeal carcinoma

Pan¹,

Qu²,

Li³

et al. 2020

Preprint

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Background: The value of maximal lymph nodal diameter in staging system of nasopharyngeal carcinoma (NPC) is not well established.Methods: NPC patients were extracted from SEER database between 2004 and 2016. Overall survival (OS) and cancer-specific survival (CSS) were compared among three groups based on the maximal lymph nodal diameter: ≤3.0 cm, >3.0-6.0 cm, and >6.0 cm. Included patients were randomly divided into training set and validated set with 1:1 ratio. In training set, X-tile plots were created by dividing maximal lymph nodal diameter into three populations. All possible divisions of the maximal lymph nodal diameter were assessed. Two cut-off values were calculated by the X-tile plots in training set. The two cut-off values were evaluated in validated set.Results: The 10-year OS and CSS were different between the three groups. Multivariate regression analysis revealed that maximal lymph nodal diameter >6.0 cm was an independent risk prognostic factor for OS (hazard ratio [HR]=1.91, 95% confidence interval [CI]: 1.51-2.43; P<0.001) and CSS (HR=1.99, 95% CI: 1.51-2.61; P<0.001). The cut-off values of maximal lymph nodal diameter were 1.3 cm and 5.0 cm using X-tile plots in the training set. In the validated set, the maximal lymph nodal diameter >5.0 cm was a risk prognostic factor for OS and CSS.Conclusions: The maximal lymph nodal diameter of 5.0 cm may be a reasonable cut-off value for N stage.

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Prognostic utility of 18F-FDG PET-CT performed prior to and during primary radiotherapy for nasopharyngeal carcinoma: Index node is a useful prognostic imaging biomarker site

Cited by 31 publications

References 23 publications

Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients

Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients

Prognostic value of pretreatment ¹⁸F-FDG PET-CT for nasopharyngeal carcinoma patients.

Maximal lymph nodal diameter in staging system of nasopharyngeal carcinoma

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Prognostic utility of 18F-FDG PET-CT performed prior to and during primary radiotherapy for nasopharyngeal carcinoma: Index node is a useful prognostic imaging biomarker site

Cited by 31 publications

References 23 publications

Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients

Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients

Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients.

Maximal lymph nodal diameter in staging system of nasopharyngeal carcinoma

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Prognostic value of pretreatment ¹⁸F-FDG PET-CT for nasopharyngeal carcinoma patients.