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Prognostic Value of FDG-PET in patients with oropharyngeal carcinoma treated with concurrent chemoradiotherapy.

Enomoto K, Inohara H, Higuchi I, Hamada K, Tomiyama Y, Kubo T, Hatazawa J - Mol Imaging Biol (2008)

Bottom Line: The prognostic performance of post-CRT PET and CT for recurrence was compared.Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070).The prognostic accuracy of post-CRT PET is superior to that of CT.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Osaka University School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. keisuke.enomoto@tracer.med.osaka-u.ac.jp

ABSTRACT

Purpose: The purpose of this study was to evaluate the predictive value of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) following concurrent chemoradiotherapy (CRT) on survival in patients with carcinoma of the oropharynx (OPC).

Methods: Eighteen patients with primary OPC who underwent PET pre- and post-CRT were evaluated prospectively for survival. The prognostic performance of post-CRT PET and CT for recurrence was compared.

Results: Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070). Other factors, such as clinical and pre-CRT PET variables, also did not indicate any significant difference. The accuracy of prediction of residual and local recurrence for post-CRT PET and CT (local%/regional%) was 83%/94% and 83%/78%, respectively.

Conclusion: OPC patients with positive post-CRT PET exhibit poor survival. The prognostic accuracy of post-CRT PET is superior to that of CT. The results of post-CRT FDG-PET should be included in the management of the OPC patients.

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Related in: MedlinePlus

Cause-specific survival (CSS) and disease-free survival (DFS) according to the loco-regional score in post-CRT PET and CT scans. The patients with negative post-CRT PET had statistically superior CSS than patients with PET positive (a, P = 0.045). The positive post-CRT PET scan was a strong predictor of DFS (b, P < 0.0001). However, negative correlations were observed between post-CRT CT scan and survival (CSS and DFS) in OPC patients treated with concurrent CRT (c, P = 0.416; d, P = 0.070).
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Fig2: Cause-specific survival (CSS) and disease-free survival (DFS) according to the loco-regional score in post-CRT PET and CT scans. The patients with negative post-CRT PET had statistically superior CSS than patients with PET positive (a, P = 0.045). The positive post-CRT PET scan was a strong predictor of DFS (b, P < 0.0001). However, negative correlations were observed between post-CRT CT scan and survival (CSS and DFS) in OPC patients treated with concurrent CRT (c, P = 0.416; d, P = 0.070).

Mentions: We evaluated the ability of pre- and post-CRT FDG-PET to predict long-term survival. In univariate analysis, patients with a positive visual score of post-CRT FDG-PET exhibited significantly lower 2-year CSS and DFS (50% vs. 91%, P = 0.045 and 0% vs. 83%, P < 0.0001), but patients with a positive RECIST score of the post-CRT CT scan did not exhibit a statistically lower 2-year CSS and DFS (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070; Fig. 2). No other factors, clinical or pre-CRT PET variables differed regarding survival.Fig. 2


Prognostic Value of FDG-PET in patients with oropharyngeal carcinoma treated with concurrent chemoradiotherapy.

Enomoto K, Inohara H, Higuchi I, Hamada K, Tomiyama Y, Kubo T, Hatazawa J - Mol Imaging Biol (2008)

Cause-specific survival (CSS) and disease-free survival (DFS) according to the loco-regional score in post-CRT PET and CT scans. The patients with negative post-CRT PET had statistically superior CSS than patients with PET positive (a, P = 0.045). The positive post-CRT PET scan was a strong predictor of DFS (b, P < 0.0001). However, negative correlations were observed between post-CRT CT scan and survival (CSS and DFS) in OPC patients treated with concurrent CRT (c, P = 0.416; d, P = 0.070).
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2480511&req=5

Fig2: Cause-specific survival (CSS) and disease-free survival (DFS) according to the loco-regional score in post-CRT PET and CT scans. The patients with negative post-CRT PET had statistically superior CSS than patients with PET positive (a, P = 0.045). The positive post-CRT PET scan was a strong predictor of DFS (b, P < 0.0001). However, negative correlations were observed between post-CRT CT scan and survival (CSS and DFS) in OPC patients treated with concurrent CRT (c, P = 0.416; d, P = 0.070).
Mentions: We evaluated the ability of pre- and post-CRT FDG-PET to predict long-term survival. In univariate analysis, patients with a positive visual score of post-CRT FDG-PET exhibited significantly lower 2-year CSS and DFS (50% vs. 91%, P = 0.045 and 0% vs. 83%, P < 0.0001), but patients with a positive RECIST score of the post-CRT CT scan did not exhibit a statistically lower 2-year CSS and DFS (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070; Fig. 2). No other factors, clinical or pre-CRT PET variables differed regarding survival.Fig. 2

Bottom Line: The prognostic performance of post-CRT PET and CT for recurrence was compared.Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070).The prognostic accuracy of post-CRT PET is superior to that of CT.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Osaka University School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. keisuke.enomoto@tracer.med.osaka-u.ac.jp

ABSTRACT

Purpose: The purpose of this study was to evaluate the predictive value of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) following concurrent chemoradiotherapy (CRT) on survival in patients with carcinoma of the oropharynx (OPC).

Methods: Eighteen patients with primary OPC who underwent PET pre- and post-CRT were evaluated prospectively for survival. The prognostic performance of post-CRT PET and CT for recurrence was compared.

Results: Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070). Other factors, such as clinical and pre-CRT PET variables, also did not indicate any significant difference. The accuracy of prediction of residual and local recurrence for post-CRT PET and CT (local%/regional%) was 83%/94% and 83%/78%, respectively.

Conclusion: OPC patients with positive post-CRT PET exhibit poor survival. The prognostic accuracy of post-CRT PET is superior to that of CT. The results of post-CRT FDG-PET should be included in the management of the OPC patients.

Show MeSH
Related in: MedlinePlus