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The Anatomical Biological Value on Pretreatment (18)F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography Predicts Response and Survival in Locally Advanced Head and Neck Cancer.

Ashamalla H, Mattes M, Guirguis A, Zaidi A, Mokhtar B, Tejwani A - World J Nucl Med (2014)

Bottom Line: This difference was maximized at a cut-off ABVmax of 30 and those patients with ABVmax < 30 were significantly more likely to have a CR compared to those with ABVmax of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023).The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028).Multivariate analysis confirmed that ABVmax was an independent prognostic factor.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, NY Methodist Hospital, Weill Medical College of Cornell University, Brooklyn, NY 11215, USA ; Department of Radiation Oncology, Leading Edge Radiation Oncology Services, Brooklyn, NY 11209, USA.

ABSTRACT
(18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has become increasingly relevant in the staging of head and neck cancers, but its prognostic value is controversial. The objective of this study was to evaluate different PET/CT parameters for their ability to predict response to therapy and survival in patients treated for head and neck cancer. A total of 28 consecutive patients with a variety of newly diagnosed head and neck cancers underwent PET/CT scanning at our institution before initiating definitive radiation therapy. All underwent a posttreatment PET/CT to gauge tumor response. Pretreatment PET/CT parameters calculated include the standardized uptake value (SUV) and the anatomical biological value (ABV), which is the product of SUV and greatest tumor diameter. Maximum and mean values were studied for both SUV and ABV, and correlated with response rate and survival. The mean pretreatment tumor ABVmax decreased from 35.5 to 7.9 (P = 0.0001). Of the parameters tested, only pretreatment ABVmax was significantly different among those patients with a complete response (CR) and incomplete response (22.8 vs. 65, respectively, P = 0.021). This difference was maximized at a cut-off ABVmax of 30 and those patients with ABVmax < 30 were significantly more likely to have a CR compared to those with ABVmax of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023). The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028). Multivariate analysis confirmed that ABVmax was an independent prognostic factor. Our data supports the use of PET/CT, and specifically ABVmax, as a prognostic factor in head and neck cancer. Patients who have an ABVmax ≥ 30 were more likely to have a poor outcome with chemoradiation alone, and a more aggressive trimodality approach may be indicated in these patients.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier survival estimates based on pretreatment maximum anatomical biological value
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Figure 1: Kaplan–Meier survival estimates based on pretreatment maximum anatomical biological value

Mentions: In addition, the MS for those patients with a median pretreatment ABVmax < 30 was 67 months compared with 25 months in those with an ABVmax ≥ 30, (P = 0.046), while the 5-year overall survival was 87.5% compared with 58.3%, respectively, (P = 0.028). In univariate Cox proportional analysis, ABVmax was a significant predictive parameter for survival, (P = 0.05). Figure 1 shows the Kaplan-Meier survival curve.


The Anatomical Biological Value on Pretreatment (18)F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography Predicts Response and Survival in Locally Advanced Head and Neck Cancer.

Ashamalla H, Mattes M, Guirguis A, Zaidi A, Mokhtar B, Tejwani A - World J Nucl Med (2014)

Kaplan–Meier survival estimates based on pretreatment maximum anatomical biological value
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150151&req=5

Figure 1: Kaplan–Meier survival estimates based on pretreatment maximum anatomical biological value
Mentions: In addition, the MS for those patients with a median pretreatment ABVmax < 30 was 67 months compared with 25 months in those with an ABVmax ≥ 30, (P = 0.046), while the 5-year overall survival was 87.5% compared with 58.3%, respectively, (P = 0.028). In univariate Cox proportional analysis, ABVmax was a significant predictive parameter for survival, (P = 0.05). Figure 1 shows the Kaplan-Meier survival curve.

Bottom Line: This difference was maximized at a cut-off ABVmax of 30 and those patients with ABVmax < 30 were significantly more likely to have a CR compared to those with ABVmax of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023).The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028).Multivariate analysis confirmed that ABVmax was an independent prognostic factor.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, NY Methodist Hospital, Weill Medical College of Cornell University, Brooklyn, NY 11215, USA ; Department of Radiation Oncology, Leading Edge Radiation Oncology Services, Brooklyn, NY 11209, USA.

ABSTRACT
(18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has become increasingly relevant in the staging of head and neck cancers, but its prognostic value is controversial. The objective of this study was to evaluate different PET/CT parameters for their ability to predict response to therapy and survival in patients treated for head and neck cancer. A total of 28 consecutive patients with a variety of newly diagnosed head and neck cancers underwent PET/CT scanning at our institution before initiating definitive radiation therapy. All underwent a posttreatment PET/CT to gauge tumor response. Pretreatment PET/CT parameters calculated include the standardized uptake value (SUV) and the anatomical biological value (ABV), which is the product of SUV and greatest tumor diameter. Maximum and mean values were studied for both SUV and ABV, and correlated with response rate and survival. The mean pretreatment tumor ABVmax decreased from 35.5 to 7.9 (P = 0.0001). Of the parameters tested, only pretreatment ABVmax was significantly different among those patients with a complete response (CR) and incomplete response (22.8 vs. 65, respectively, P = 0.021). This difference was maximized at a cut-off ABVmax of 30 and those patients with ABVmax < 30 were significantly more likely to have a CR compared to those with ABVmax of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023). The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028). Multivariate analysis confirmed that ABVmax was an independent prognostic factor. Our data supports the use of PET/CT, and specifically ABVmax, as a prognostic factor in head and neck cancer. Patients who have an ABVmax ≥ 30 were more likely to have a poor outcome with chemoradiation alone, and a more aggressive trimodality approach may be indicated in these patients.

No MeSH data available.


Related in: MedlinePlus