Prognostic implications of post-therapy 18 F-FDG PET in patients with locoregionally advanced nasopharyngeal carcinoma t
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ORIGINAL ARTICLE
Prognostic implications of post-therapy 18F-FDG PET in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy Sheng-Chieh Chan • Wen-Han Kuo • Hung-Ming Wang • Joseph Tung-Chieh Chang Chien-Yu Lin • Shu-Hang Ng • Cheng-Lung Hsu • Kai-Ping Chang • Chun-Ta Liao • Yu-Jr Lin • Tzu-Chen Yen
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Received: 16 March 2013 / Accepted: 9 May 2013 Ó The Japanese Society of Nuclear Medicine 2013
Abstract Objectives Reliable prognostic factors that serve as a guide to follow-up of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) have not yet been identified. We sought to investigate the prognostic implications of post-therapy PET in patients with NPC treated with chemoradiotherapy. Methods Patients with locoregionally advanced NPC (stages III and IVa–b) who had completed primary curative treatment for 3 months were eligible. All of the patients underwent 18F-FDG PET and conventional work-up (CWU) for the assessment of treatment response.
S.-C. Chan and W.-H. Kao contributed equally to this work.
Electronic supplementary material The online version of this article (doi:10.1007/s12149-013-0736-2) contains supplementary material, which is available to authorized users. S.-C. Chan Department of Nuclear Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan e-mail: [email protected] S.-C. Chan W.-H. Kuo T.-C. Yen (&) Molecular Imaging Center and Department of Nuclear Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan e-mail: [email protected] S.-C. Chan H.-M. Wang J. T.-C. Chang C.-Y. Lin S.-H. Ng C.-L. Hsu K.-P. Chang C.-T. Liao T.-C. Yen Head and Neck Oncology Team (Group), Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan
Results A total of 165 patients were enrolled. Over a median follow-up of 58 months, 30 patients died and 41 had disease recurrence. The results of the 3-month posttherapy PET and total lesion glycolysis (TLG) of the primary tumor were independent predictors of overall survival. TNM tumor stage, TLG, and post-therapy PET findings were independently associated with disease-free survival (DFS). The results of post-therapy PET were more predictive of DFS than TNM tumor stage (P \ 0.001 vs. P = 0.005). Among patients with stage IVa–b disease, there was a trend toward better 5-DFS rates in patients with a complete metabolic response (CMR) on PET than in those who showed a complete response in the CWU (5year DFS = 70.7 vs. 63.1 %). Notably, the 1- and 2-year DFS rates were significantly better in the former group compared with the latter. In contrast, the results of posttherapy CWU were not a reliable predictor for DFS. J. T.-C. Chang C.-Y. Lin Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan S.-H. Ng Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan K.-P. Chang C.-T. Liao Department of Otorhinolaryngology, Lin
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