Fluorodeoxyglucose Positron Emission Tomography as Predictive Factor for the Outcome of Head and Neck Cancer Patients
Abstract
Objectives: The aim of this study was to determine if fluorodeoxyglucose positron emission tomography (FDG-PET) uptake can be used in pretreatment assessment as an additional prognostic factor for outcome in head and neck cancer patients receiving radiotherapy by helical tomotherapy (Hi-Art TomotherapyŽ) +/- chemotherapy.
Methods: Between June 2005 and March 2008, 58 patients with a biopsy proven head and neck cancer (HNC) were treated at the Universitair Ziekenhuis Brussel (UZ Brussel). All patients underwent a baseline FDG-PET before treatment. The maximum Standardized Uptake Value (SUVmax) was measured within the lesions. Median SUVmax was used as a cutoff to categorize patients into high and low SUVmax groups.
Results: Median SUVmax = 7.92. Median SUVmax for patients who died was significantly higher than living patients (9.16 vs. 7.32, respectively, p= 0.037). 3-years Overall survival (OS) was 80% vs. 54% (p = 0.009) and disease free survival (DFS) was 83% vs. 41% (p = 0.018) for low and high SUVmax groups, respectively. Multivariate analysis also confirmed these observations.
Conclusion: PET-FDG scan before treatment is a good predictor of outcome in HNC patients. It may helps in early identification of patients with poor prognosis for perhaps other therapeutic approaches.
Keywords: FDG-PET; SUV; Helical Tomotherapy; Head and Neck Cancer; Predictive Factor