European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2007
2-[18F]-Fluoro-2-deoxy-D-glucose positron emission tomography as guidance for primary treatment in patients with advanced-stage resectable squamous cell carcinoma of the larynx and hypopharynx.
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Roh J-L, Pae K H, Choi S-H, Kim J S, Lee S, Kim S-B, Nam S Y, Kim S Y
Аннотация
BACKGROUND: High uptake of 2-[(18)F]-fluoro-2-deoxy-D-glucose (FDG) is associated with unfavorable results. Pretreatment FDG uptake was evaluated as a predictor of survival and guidance for primary surgery or radiotherapy (RT) in patients with squamous cell carcinoma (SCC) of the larynx and hypopharynx.
MATERIALS AND METHODS: Seventy-nine consecutive patients with newly diagnosed advanced resectable SCC of the larynx and hypopharynx underwent FDG positron emission tomography (PET) before surgical resection plus RT and chemotherapy (surgery group, n=40) or RT with chemotherapy and surgical salvage (RT group, n=39). Age, tumor stage, histological grade, treatment strategy, and standardized uptake value (SUV) were analyzed for association with local control and survival.
RESULTS: Overall local control and survival in the two groups did not differ (P>0.1). In univariate analysis, nodal positivity (P=0.014) and SUV>8.0 (P=0.007) were associated with poorer disease-free survival (DFS). In multivariate analysis, SUV remained an independent determinant of DFS (P=0.014). When patients with SUV>8.0 in the two treatment groups were analyzed separately, those in the surgery group tended to have a higher 3-year DFS than those in the RT group, despite no statistical significance (48% vs. 27%, P=0.085).
CONCLUSIONS: High FDG uptake is associated with poor survival in patients with advanced laryngopharyngeal SCC. Patients with high FDG uptake may be better treated by surgical resection followed by RT and chemotherapy.
MATERIALS AND METHODS: Seventy-nine consecutive patients with newly diagnosed advanced resectable SCC of the larynx and hypopharynx underwent FDG positron emission tomography (PET) before surgical resection plus RT and chemotherapy (surgery group, n=40) or RT with chemotherapy and surgical salvage (RT group, n=39). Age, tumor stage, histological grade, treatment strategy, and standardized uptake value (SUV) were analyzed for association with local control and survival.
RESULTS: Overall local control and survival in the two groups did not differ (P>0.1). In univariate analysis, nodal positivity (P=0.014) and SUV>8.0 (P=0.007) were associated with poorer disease-free survival (DFS). In multivariate analysis, SUV remained an independent determinant of DFS (P=0.014). When patients with SUV>8.0 in the two treatment groups were analyzed separately, those in the surgery group tended to have a higher 3-year DFS than those in the RT group, despite no statistical significance (48% vs. 27%, P=0.085).
CONCLUSIONS: High FDG uptake is associated with poor survival in patients with advanced laryngopharyngeal SCC. Patients with high FDG uptake may be better treated by surgical resection followed by RT and chemotherapy.
Предметные рубрики MeSH
AdultAgedAged, 80 and overCarcinoma, Squamous CellChemotherapy, AdjuvantCohort StudiesDisease-Free SurvivalFemaleFluorodeoxyglucose F18Follow-Up StudiesForecastingHumansHypopharyngeal NeoplasmsLaryngeal NeoplasmsMaleMiddle AgedNeoadjuvant TherapyNeoplasm Recurrence, LocalNeoplasm StagingPatient Care PlanningPositron-Emission TomographyRadiopharmaceuticalsRadiotherapy, AdjuvantSalvage TherapySurvival RateTreatment Outcome