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Pretreatment FDG-PET standardized uptake value as a prognostic factor for outcome in head and neck cancer
Mitchell Machtay1, Mona Natwa, Jocelyn Andrel
1Department of Radiation Oncology, Jefferson Medical College and the Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. mitchell.machtay@mail.tju.edu
Background:
We studied the potential prognostic significance of pretreatment 18-fluorodeoxyglucose-positron emission tomography (FDG-PET) standardized uptake value (SUV) in squamous cell carcinoma of the head and neck (SCCHN).
Methods:
A retrospective review of the pretreatment FDG-PET scans of 60 patients with SCCHN was performed. All patients received radiotherapy and 37 also received concurrent chemotherapy. SUV was calculated by 2 nuclear-medicine physicians who were blinded to the clinical data. Disease-free survival (DFS) was analyzed with respect to SUV (and other potential prognostic factors).
Results:
The median SUV was 7.2 (range, 1-24.7); 34 patients (57%) had SUV < 9.0 compared with 26 patients (43%) with an SUV > or = 9.0. The group with low SUV had significantly better 2-year DFS compared with the high SUV group (72% vs 37%), p = .007. On multivariate analysis, stage and age were also associated with DFS, but SUV remained an independent predictor of DFS (hazard ratio: 1.08; p = .016).
Conclusion:
SUV was significantly associated with outcome after modern definitive therapy of SCCHN.
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