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18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization
PURPOSE: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is utilized for staging and treatment planning of head and neck squamous cell carcinomas (HNSCC). Some older publications on the prognostic relevance showed inconclusive results, most probably due to small study sizes. This study...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213669/ https://www.ncbi.nlm.nih.gov/pubmed/35756665 http://dx.doi.org/10.3389/fonc.2022.870319 |
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author | Zschaeck, Sebastian Weingärtner, Julian Lombardo, Elia Marschner, Sebastian Hajiyianni, Marina Beck, Marcus Zips, Daniel Li, Yimin Lin, Qin Amthauer, Holger Troost, Esther G. C. van den Hoff, Jörg Budach, Volker Kotzerke, Jörg Ferentinos, Konstantinos Karagiannis, Efstratios Kaul, David Gregoire, Vincent Holzgreve, Adrien Albert, Nathalie L. Nikulin, Pavel Bachmann, Michael Kopka, Klaus Krause, Mechthild Baumann, Michael Kazmierska, Joanna Cegla, Paulina Cholewinski, Witold Strouthos, Iosif Zöphel, Klaus Majchrzak, Ewa Landry, Guillaume Belka, Claus Stromberger, Carmen Hofheinz, Frank |
author_facet | Zschaeck, Sebastian Weingärtner, Julian Lombardo, Elia Marschner, Sebastian Hajiyianni, Marina Beck, Marcus Zips, Daniel Li, Yimin Lin, Qin Amthauer, Holger Troost, Esther G. C. van den Hoff, Jörg Budach, Volker Kotzerke, Jörg Ferentinos, Konstantinos Karagiannis, Efstratios Kaul, David Gregoire, Vincent Holzgreve, Adrien Albert, Nathalie L. Nikulin, Pavel Bachmann, Michael Kopka, Klaus Krause, Mechthild Baumann, Michael Kazmierska, Joanna Cegla, Paulina Cholewinski, Witold Strouthos, Iosif Zöphel, Klaus Majchrzak, Ewa Landry, Guillaume Belka, Claus Stromberger, Carmen Hofheinz, Frank |
author_sort | Zschaeck, Sebastian |
collection | PubMed |
description | PURPOSE: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is utilized for staging and treatment planning of head and neck squamous cell carcinomas (HNSCC). Some older publications on the prognostic relevance showed inconclusive results, most probably due to small study sizes. This study evaluates the prognostic and potentially predictive value of FDG-PET in a large multi-center analysis. METHODS: Original analysis of individual FDG-PET and patient data from 16 international centers (8 institutional datasets, 8 public repositories) with 1104 patients. All patients received curative intent radiotherapy/chemoradiation (CRT) and pre-treatment FDG-PET imaging. Primary tumors were semi-automatically delineated for calculation of SUV(max), SUV(mean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Cox regression analyses were performed for event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM). RESULTS: FDG-PET parameters were associated with patient outcome in the whole cohort regarding clinical endpoints (EFS, OS, LRC, FFDM), in uni- and multivariate Cox regression analyses. Several previously published cut-off values were successfully validated. Subgroup analyses identified tumor- and human papillomavirus (HPV) specific parameters. In HPV positive oropharynx cancer (OPC) SUV(max) was well suited to identify patients with excellent LRC for organ preservation. Patients with SUV(max) of 14 or less were unlikely to develop loco-regional recurrence after definitive CRT. In contrast FDG PET parameters deliver only limited prognostic information in laryngeal cancer. CONCLUSION: FDG-PET parameters bear considerable prognostic value in HNSCC and potential predictive value in subgroups of patients, especially regarding treatment de-intensification and organ-preservation. The potential predictive value needs further validation in appropriate control groups. Further research on advanced imaging approaches including radiomics or artificial intelligence methods should implement the identified cut-off values as benchmark routine imaging parameters. |
format | Online Article Text |
id | pubmed-9213669 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92136692022-06-23 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization Zschaeck, Sebastian Weingärtner, Julian Lombardo, Elia Marschner, Sebastian Hajiyianni, Marina Beck, Marcus Zips, Daniel Li, Yimin Lin, Qin Amthauer, Holger Troost, Esther G. C. van den Hoff, Jörg Budach, Volker Kotzerke, Jörg Ferentinos, Konstantinos Karagiannis, Efstratios Kaul, David Gregoire, Vincent Holzgreve, Adrien Albert, Nathalie L. Nikulin, Pavel Bachmann, Michael Kopka, Klaus Krause, Mechthild Baumann, Michael Kazmierska, Joanna Cegla, Paulina Cholewinski, Witold Strouthos, Iosif Zöphel, Klaus Majchrzak, Ewa Landry, Guillaume Belka, Claus Stromberger, Carmen Hofheinz, Frank Front Oncol Oncology PURPOSE: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is utilized for staging and treatment planning of head and neck squamous cell carcinomas (HNSCC). Some older publications on the prognostic relevance showed inconclusive results, most probably due to small study sizes. This study evaluates the prognostic and potentially predictive value of FDG-PET in a large multi-center analysis. METHODS: Original analysis of individual FDG-PET and patient data from 16 international centers (8 institutional datasets, 8 public repositories) with 1104 patients. All patients received curative intent radiotherapy/chemoradiation (CRT) and pre-treatment FDG-PET imaging. Primary tumors were semi-automatically delineated for calculation of SUV(max), SUV(mean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Cox regression analyses were performed for event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM). RESULTS: FDG-PET parameters were associated with patient outcome in the whole cohort regarding clinical endpoints (EFS, OS, LRC, FFDM), in uni- and multivariate Cox regression analyses. Several previously published cut-off values were successfully validated. Subgroup analyses identified tumor- and human papillomavirus (HPV) specific parameters. In HPV positive oropharynx cancer (OPC) SUV(max) was well suited to identify patients with excellent LRC for organ preservation. Patients with SUV(max) of 14 or less were unlikely to develop loco-regional recurrence after definitive CRT. In contrast FDG PET parameters deliver only limited prognostic information in laryngeal cancer. CONCLUSION: FDG-PET parameters bear considerable prognostic value in HNSCC and potential predictive value in subgroups of patients, especially regarding treatment de-intensification and organ-preservation. The potential predictive value needs further validation in appropriate control groups. Further research on advanced imaging approaches including radiomics or artificial intelligence methods should implement the identified cut-off values as benchmark routine imaging parameters. Frontiers Media S.A. 2022-06-08 /pmc/articles/PMC9213669/ /pubmed/35756665 http://dx.doi.org/10.3389/fonc.2022.870319 Text en Copyright © 2022 Zschaeck, Weingärtner, Lombardo, Marschner, Hajiyianni, Beck, Zips, Li, Lin, Amthauer, Troost, van den Hoff, Budach, Kotzerke, Ferentinos, Karagiannis, Kaul, Gregoire, Holzgreve, Albert, Nikulin, Bachmann, Kopka, Krause, Baumann, Kazmierska, Cegla, Cholewinski, Strouthos, Zöphel, Majchrzak, Landry, Belka, Stromberger and Hofheinz https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Zschaeck, Sebastian Weingärtner, Julian Lombardo, Elia Marschner, Sebastian Hajiyianni, Marina Beck, Marcus Zips, Daniel Li, Yimin Lin, Qin Amthauer, Holger Troost, Esther G. C. van den Hoff, Jörg Budach, Volker Kotzerke, Jörg Ferentinos, Konstantinos Karagiannis, Efstratios Kaul, David Gregoire, Vincent Holzgreve, Adrien Albert, Nathalie L. Nikulin, Pavel Bachmann, Michael Kopka, Klaus Krause, Mechthild Baumann, Michael Kazmierska, Joanna Cegla, Paulina Cholewinski, Witold Strouthos, Iosif Zöphel, Klaus Majchrzak, Ewa Landry, Guillaume Belka, Claus Stromberger, Carmen Hofheinz, Frank 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
title | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
title_full | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
title_fullStr | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
title_full_unstemmed | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
title_short | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
title_sort | 18f-fluorodeoxyglucose positron emission tomography of head and neck cancer: location and hpv specific parameters for potential treatment individualization |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213669/ https://www.ncbi.nlm.nih.gov/pubmed/35756665 http://dx.doi.org/10.3389/fonc.2022.870319 |
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