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Annals of Oncology Advance Access published online on November 13, 2009
Annals of Oncology, doi:10.1093/annonc/mdp430
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Prognostic value of 18F-FDG PET/CT before and after radiotherapy for locally advanced nasopharyngeal carcinoma

P. Xie, J.-B. Yue, Z. Fu, R. Feng and J.-M. Yu

Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan, China

* Correspondence to: Dr J.-M. Yu, Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jiyan Road 440, Jinan 250117, Shandong Province, China. Tel: +86-13806406293; Fax: +86-531-87984729; E-mail: yujmwin{at}yahoo.cn

Background: The purpose of this study was to evaluate the prognostic value of maximal standard uptake values (SUVsmax) from serial fluor-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with locally advanced nasopharyngeal carcinoma (NPC).

Materials and methods: From October 2002 to January 2004, 62 patients with locally advanced NPC who underwent 18F-FDG PET/CT scan before and after radiotherapy were reviewed retrospectively. We examined the association of SUVmax and the results of long-term follow-up of the patients.

Results: Patients having tumors with a lower SUVmax had significantly better 5-year overall survival (OS) (P= 0.0187) and disease-free survival (DFS) (P = 0.0163) than patients with a greater SUVmax. The patients who showed with metabolic complete response had a significantly higher 5-year OS (P = 0.0237) and DFS (P = 0.0186) than patients with metabolic partial response. Poor prognosis was found in patients with the SUVmax of neck nodes larger than that at the primary tumor site (SUVmax-N > SUVmax-P) (P = 0.0440).

Conclusions: 18F-FDG uptake, as measured by the SUVmax before radiotherapy and metabolic response after radiotherapy, may predict the prognosis in locally advanced NPC. High 18F-FDG uptake before and after radiotherapy may be useful for identifying patients requiring more aggressive treatment.

18F-FDG, nasopharyngeal neoplasms, PET/CT, prognosis, radiotherapy

Received for publication February 5, 2009. Revision received June 6, 2009. Revision received July 28, 2009. Accepted for publication August 3, 2009.


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