18F-FDG-PET for evaluation of the response to concurrent chemoradiation therapy with intensity-modulated radiation technique for Stage T4 nasopharyngeal carcinoma

Yen, Tzu-Chen; Lin, Chien-Yu; Wang, Hung-Ming; Huang, Shiang-Fu; Liao, Chun-Ta; Kang, Chung-Jan; Ng, Shu-Hang; Chan, Sheng-Chieh; Fan, Kang-Hsing; Chen, I.-How; Lin, Wuu-Jyh; Cheng, Ann-Joy; Chang, Joseph Tung-Chieh

doi:10.1016/j.ijrobp.2006.02.031

« Previous Next »International Journal of Radiation Oncology * Biology * Physics
Volume 65, Issue 5 , Pages 1307-1314, 1 August 2006

¹⁸F-FDG-PET for evaluation of the response to concurrent chemoradiation therapy with intensity-modulated radiation technique for Stage T4 nasopharyngeal carcinoma

This article was presented at the Forty-Seventh Annual Meeting of the American Society for Therapeutic Radiology and Oncology, October 16–20, 2005, Denver, CO.

Tzu-Chen Yen, M.D., Ph.D.
- Molecular Imaging Center, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Chien-Yu Lin, M.D.
- Department of Nuclear Medicine, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Hung-Ming Wang, M.D.
- Department of Radiation Oncology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Shiang-Fu Huang, M.D.
- Department of Medical Oncology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Chun-Ta Liao, M.D.
- Department of Medical Oncology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Chung-Jan Kang, M.D.
- Department of Medical Oncology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Shu-Hang Ng, M.D.
- Department of Otorhinolaryngology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Sheng-Chieh Chan, M.D.
- Molecular Imaging Center, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Kang-Hsing Fan, M.D.
- Department of Nuclear Medicine, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
I.-How Chen, M.D.
- Department of Medical Oncology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Wuu-Jyh Lin, Ph.D.
- Institute of Nuclear Energy Research, Taoyuan, Taiwan
Ann-Joy Cheng, Ph.D.
- Department of Medical Biotechnology, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
Joseph Tung-Chieh Chang, M.D., M.H.A.
- Department of Nuclear Medicine, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital–Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
- Reprint requests to: Joseph Tung-Chieh Chang, M.D., M.H.A., Department of Radiation Oncology, Chang Gung Memorial University Hospital, Linkou Medical Center, 5 Fu-Shin St, Kueishan, Taoyuan 333, Taiwan. Tel: (+886) 3-3281200 ext. 2613; Fax: (+886) 3-3280797

Received 9 November 2005; received in revised form 22 February 2006; accepted 22 February 2006.

Purpose: This article evaluates [¹⁸F] fluorodeoxyglucose positron emission tomography (¹⁸F-FDG-PET) findings as a predictor for local responders (R) vs. nonresponders (NR) in nasopharyngeal carcinoma (NPC) patients with Stage T4 lesions, before and at 3 months after completion of concurrent chemotherapy and radiation therapy (CCRT).

Methods and Materials: From January 2002 to November 2003, 39 T4 NPC patients were enrolled. All had magnetic resonance imaging and ¹⁸F-FDG-PET, both before and 3 months after CCRT. Any residual/recurrent lesions were confirmed histopathologically.

Results: Of the 39 eligible patients, after a follow-up of 24.2 ± 9.5 months, 35 became disease-free and 4 had residual or recurrent disease. Marginal differences in standard uptake values (SUV) were observed (10.9 ± 5.3 vs. 15.6 ± 3.4, p = 0.058) between R and NR before treatment, and value changes of SUV before and after CCRT were not significantly different. However, highly significantly lower values of SUV were noted for R than for NR 3 months after completion of CCRT (2.1 ± 0.8 vs. 5.5 ± 3.2, p = 0.001). One hundred percent positive and negative predictive values were observed for SUV values of 4.0, set 3 months after completion of CCRT.

Conclusions: Neither the pretreatment SUV nor the changes of SUV between pretreatment and posttreatment were significant predictors for local response. SUV at 3 months after completion of CCRT was a significant determinator for local response. The cutoff of 4.0 for SUV at 3 months after completion of CCRT was useful to be offered as a diagnostic reference for recurrent or residual tumor for NPC treatment.

Keywords: Nasopharyngeal carcinoma , ¹⁸F-FDG-PET , Response , Concurrent chemotherapy and radiation therapy

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This research is supported by grants NSC 92-2314-B-182A-081 (Dr. Ng) from the National Science Council-Taiwan and CMRPG32034 (Dr. Yen) from the Chang Gung Memorial Hospital and University.

PII: S0360-3016(06)00388-9

doi:10.1016/j.ijrobp.2006.02.031

« Previous Next »International Journal of Radiation Oncology * Biology * Physics
Volume 65, Issue 5 , Pages 1307-1314, 1 August 2006

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