Abstract：Objective To explore the prognostic value of pretreated maximum standardized uptake value (SUVmax) using 18-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG PET/CT) in locally-advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT). Methods One hundred and forty previously untreated stage Ⅲ－Ⅳb(UICC/AJCC 6th) patients with biopsy-proven nasopharyngeal carcinoma were examined. All of the enrolled patients accepted whole body/head-neck 18FDG PET/CT before radical IMRT. 18FDG uptakes were recorded as SUVmax of primary tumor (SUVmax-P) and SUVmax of cervical lymph nodes (SUVmax-N). The relationships between SUVmax and long-term clinical outcomes were analyzed. Results The median SUVmax-P was 10.4, and the median SUVmax-N was 6.2. The SUVmax-P was weakly correlated with T-stage (R=0.279, P=0.001). The SUVmax-N was weakly correlated with N stage (R=0.334, P=0.000). There were no difference of the median SUVmax-P (9.2 vs.10.4,U=560.50,P=0.805) and the median SUVmax-N (4.0 vs.5.0,U=576.00,P=0.908) between patients with and without local recurrence. The median SUVmax-P of patients with distant metastasis was significantly higher than those without metastasis (11.9 vs. 9.8, U=987.50,P=0.014). The SUV of 10.2 was taken as a cut-off for high and low uptake tumors. For patients with SUVmax-P>10.2, the 5-year distant metastasis-free survival (DMFS) and 5-year overall survival (OS) were significantly higher than those with SUVmax-P≤10.2(69.1% vs. 95.5%,χ2=15.88, P=0.000;68.4% vs. 94.0%,χ2=15.56,P=0.000, respectively). Multivariate analysis showed that SUVmax-P was the only independent risk factor of 5-year DMFS and OS (HR=7.87,P=0.001 and HR=5.14,P=0.003).Conclusion SUVmax-P is a useful biomarker predicting long-term clinical outcomes in newly diagnosed locally-advanced NPC patients.
XU An-an,HAN Fei,LU Li-xia et al. The role of pretreatment FDG standard uptake value in predicting for clinical outcome in locally-advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(3): 209-213.
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