1. Early metabolic 18F-FDG PET/CT response of locally advanced squamous-cell carcinoma of head and neck to induction chemotherapy: A prospective pilot study.
- Author
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Nicolau, Ulisses Ribaldo, de Jesus, Victor Hugo Fonseca, Lima, Eduardo Nóbrega Pereira, Alves, Marclesson Santos, de Oliveira, Thiago Bueno, Andrade, Louise De Brot, Silva, Virgilio Souza, Bes, Paula Cacciatore, Jrde Paiva, Tadeu Ferreira, Calsavara, Vinicius Fernando, Guimarães, Andrea Paiva Gadelha, Cezana, Loureno, Barbosa, Paula Nicole Vieira Pinto, Porto, Gislaine Cristina Lopes Machado, Pellizzon, Antônio Cássio Assis, de Carvalho, Genival Barbosa, and Kowalski, Luiz Paulo
- Subjects
SQUAMOUS cell carcinoma ,POSITRON emission tomography ,FLUORODEOXYGLUCOSE F18 ,PROGRESSION-free survival ,CHEMORADIOTHERAPY - Abstract
Objective: The objective of this study was to assess the clinical value of 18-fluorodeoxyglucose positron emission tomography/computed tomography (
18 F-FDG PET/CT) after the first cycle of induction chemotherapy (IC) in locally advanced squamous cell carcinoma of the head and neck (LASCCHN). Methods and findings: A prospective, single-arm, single center study was performed, with patients enrolled between February 2010 and July 2013.Patients (n = 49) with stage III/IVA–B LASCCHN who underwent IC with taxanes, cisplatin, and fluorouracil were recruited. Staging procedures included loco-regional and chest imaging, endoscopic examination, and PET/CT scan. On day 14 of the first cycle, a second PET/CT scan was performed. Patients with no early increase in regional lymph node maximum18 F-FDG standard uptake value (SUV), detected using18 F-FDG PET/CT after first IC had better progression-free survival (hazard ratio (HR) = 0.18, 95%, confidence interval (CI) 0.056–0.585; p = 0.004) and overall survival (HR = 0.14, 95% CI 0.040–0.498; p = 0.002), and were considered responders. In this subgroup, patients who achieved a reduction of ≥ 45% maximum primary tumor SUV experienced improved progression-free (HR = 0.23, 95% CI 0.062–0.854; p = 0.028) and overall (HR = 0.11, 95% CI 0.013–0.96; p = 0.046) survival. Conclusions: These results suggest a potential role for early response evaluation with PET/CT examination in patients with LASCCHN undergoing IC. Increased regional lymph node maximum SUV and insufficient decrease in primary tumor uptake predict poorer outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2018
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