Predictive and prognostic value of PET/CT imaging post-chemoradiotherapy and clinical decision-making consequences in locally advanced head & neck squamous cell ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-02-17

AUTHORS

Ryul Kim, Chan-Young Ock, Bhumsuk Keam, Tae Min Kim, Jin Ho Kim, Jin Chul Paeng, Seong Keun Kwon, J. Hun Hah, Tack-Kyun Kwon, Dong-Wan Kim, Hong-Gyun Wu, Myung-Whun Sung, Dae Seog Heo

ABSTRACT

BackgroundThe accuracy of 18F-fluorodeoxygluocose positron emission tomography/computed tomography (PET/CT) in predicting immediate failure after radical chemoradiotherapy (CRT) for HNSCC is poorly characterized at present. The purpose of this study was to examine PET/CT as a predictive and prognostic gauge of immediate failure after CRT and determine the impact of these studies on clinical decision making in terms of salvage surgery.MethodsMedical records of 78 consecutive patients receiving radical CRT for locally advanced HNSCC were reviewed, analyzing PET/CTs done before and 3 months after CRT. Immediate failure was defined as residual disease or locoregional and/or systemic relapse within 6 months after CRT.ResultsMaximum standard uptake value (SUV) of post CRT PET/CT (postSUVmax) was found optimal for predicting immediate failure at a cutpoint of 4.4. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were 90.0 %, 83.8 %, 98.3 %, and 45.0 %, respectively. Of 78 patients studied, postSUVmax ≥4.4 prevailed in 20 (25.6 %), with postSUVmax <4.4 in 58 (74.4 %). At postSUVmax ≥4.4 (vs. postSUVmax <4.4) OS was poorer by comparison (3-year OS: 56.9 vs. 87.7 %; P = 0.005), as was progression-free survival (3-year PFS: 42.9 vs. 81.1 %; P < 0.001). At postSUVmax ≥4.4, OS with and without immediate salvage surgery did not differ significantly (3-year OS: 60.0 vs. 55.6 %; Log-rank P = 0.913).ConclusionPost CRT PET/CT imaging has prognostic value in terms of OS and PFS and is useful in predicting immediate therapeutic failure, given its high NPV. However, OS was not significantly altered by early salvage surgery done on the basis of post CRT PET/CT findings. More... »

PAGES

116

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12885-016-2147-y

DOI

http://dx.doi.org/10.1186/s12885-016-2147-y

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https://app.dimensions.ai/details/publication/pub.1008571606

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26884055


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    "description": "BackgroundThe accuracy of 18F-fluorodeoxygluocose positron emission tomography/computed tomography (PET/CT) in predicting immediate failure after radical chemoradiotherapy (CRT) for HNSCC is poorly characterized at present. The purpose of this study was to examine PET/CT as a predictive and prognostic gauge of immediate failure after CRT and determine the impact of these studies on clinical decision making in terms of salvage surgery.MethodsMedical records of 78 consecutive patients receiving radical CRT for locally advanced HNSCC were reviewed, analyzing PET/CTs done before and 3\u00a0months after CRT. Immediate failure was defined as residual disease or locoregional and/or systemic relapse within 6\u00a0months after CRT.ResultsMaximum standard uptake value (SUV) of post CRT PET/CT (postSUVmax) was found optimal for predicting immediate failure at a cutpoint of 4.4. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were 90.0\u00a0%, 83.8\u00a0%, 98.3\u00a0%, and 45.0\u00a0%, respectively. Of 78 patients studied, postSUVmax \u22654.4 prevailed in 20 (25.6\u00a0%), with postSUVmax <4.4 in 58 (74.4\u00a0%). At postSUVmax \u22654.4 (vs. postSUVmax <4.4) OS was poorer by comparison (3-year OS: 56.9 vs. 87.7\u00a0%; P\u2009=\u20090.005), as was progression-free survival (3-year PFS: 42.9 vs. 81.1\u00a0%; P\u2009<\u20090.001). At postSUVmax \u22654.4, OS with and without immediate salvage surgery did not differ significantly (3-year OS: 60.0 vs. 55.6\u00a0%; Log-rank P\u2009=\u20090.913).ConclusionPost CRT PET/CT imaging has prognostic value in terms of OS and PFS and is useful in predicting immediate therapeutic failure, given its high NPV. However, OS was not significantly altered by early salvage surgery done on the basis of post CRT PET/CT findings.", 
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26 schema:description BackgroundThe accuracy of 18F-fluorodeoxygluocose positron emission tomography/computed tomography (PET/CT) in predicting immediate failure after radical chemoradiotherapy (CRT) for HNSCC is poorly characterized at present. The purpose of this study was to examine PET/CT as a predictive and prognostic gauge of immediate failure after CRT and determine the impact of these studies on clinical decision making in terms of salvage surgery.MethodsMedical records of 78 consecutive patients receiving radical CRT for locally advanced HNSCC were reviewed, analyzing PET/CTs done before and 3 months after CRT. Immediate failure was defined as residual disease or locoregional and/or systemic relapse within 6 months after CRT.ResultsMaximum standard uptake value (SUV) of post CRT PET/CT (postSUVmax) was found optimal for predicting immediate failure at a cutpoint of 4.4. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were 90.0 %, 83.8 %, 98.3 %, and 45.0 %, respectively. Of 78 patients studied, postSUVmax ≥4.4 prevailed in 20 (25.6 %), with postSUVmax <4.4 in 58 (74.4 %). At postSUVmax ≥4.4 (vs. postSUVmax <4.4) OS was poorer by comparison (3-year OS: 56.9 vs. 87.7 %; P = 0.005), as was progression-free survival (3-year PFS: 42.9 vs. 81.1 %; P < 0.001). At postSUVmax ≥4.4, OS with and without immediate salvage surgery did not differ significantly (3-year OS: 60.0 vs. 55.6 %; Log-rank P = 0.913).ConclusionPost CRT PET/CT imaging has prognostic value in terms of OS and PFS and is useful in predicting immediate therapeutic failure, given its high NPV. However, OS was not significantly altered by early salvage surgery done on the basis of post CRT PET/CT findings.
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32 schema:keywords CRT PET/CT
33 CT
34 CT findings
35 CT imaging
36 HNSCC
37 MethodsMedical records
38 OS
39 PET/CT
40 PET/CT findings
41 PET/CT imaging
42 PFS
43 accuracy
44 advanced HNSCC
45 advanced head
46 basis
47 carcinoma
48 cell carcinoma
49 chemoradiotherapy
50 clinical decision
51 comparison
52 consecutive patients
53 consequences
54 cutpoints
55 decision-making consequences
56 decisions
57 disease
58 early salvage surgery
59 emission tomography/
60 failure
61 findings
62 gauge
63 head
64 high negative predictive value
65 imaging
66 immediate failure
67 immediate salvage surgery
68 impact
69 months
70 neck squamous cell carcinoma
71 negative predictive value
72 patients
73 positive predictive value
74 positron emission tomography/
75 predictive value
76 present
77 prognostic gauge
78 prognostic value
79 progression-free survival
80 purpose
81 radical chemoradiotherapy
82 records
83 relapse
84 residual disease
85 retrospective study
86 salvage surgery
87 sensitivity
88 specificity
89 squamous cell carcinoma
90 standard uptake value
91 study
92 surgery
93 survival
94 systemic relapse
95 terms
96 terms of OS
97 therapeutic failure
98 tomography
99 tomography/
100 uptake value
101 values
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