Predictive Value of ¹⁸F-FDG PET/CT in LA-HNSCC Patients Undergoing Neoadjuvant Chemoimmunotherapy: A Prospective...

The study evaluates the efficacy of ¹⁸F-2-fluoro-2-deoxy-d-glucose FDG PET/CT in predicting outcomes in patients with advanced head and neck squamous cell carcinoma receiving neoadjuvant chemoimmunotherapy.

In this prospective study, we compared the parameters of 63 patients with LA-HNSCC who underwent ¹⁸F-FDG PET/CT before neoadjuvant chemoimmunotherapy, divided into responders (47) and non-responders (16), after three cycles of neoadjuvant chemoimmunotherapy. The ratio of the maximum standardized uptake value (SUVmax) of the primary tumor to the SUVmean of the normal tissue (muscle and blood) was recorded as the target background ratio (TBR muscle and TBR blood).

The SUVmean and TBRblood of the primary tumor were significantly lower in the responding group than in the non-responding group. Receiver operating characteristic (ROC) curve analysis identified SUVmean (area under the curve (AUC) = 0.931, p = 0.001) and TBRblood (AUC = 0.894, p = 0.001) as significant predictors of neoadjuvant chemoimmunotherapy efficacy. The study found that SUVmean, TBRblood, age, and Eastern Cooperative Oncology Group (ECOG) scores significantly correlated with short-term efficacy, while SUVmean was an independent predictor.

In ¹⁸F-FDG PET/CT scans, higher baseline SUVmean and TBRblood were associated with a poor short-term response to neoadjuvant chemoradiotherapy in patients with LA-HNSCC.