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18F-fluorodeoxyglucose positron emission tomography of head and neck cancer: location and HPV specific parameters for potential treatment individualization

Purpose18F-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 e...

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Main Authors: Zschaeck, Sebastian (Author) , Weingärtner, Julian (Author) , Lombardo, Elia (Author) , Marschner, Sebastian (Author) , Hajiyianni, Marina (Author) , Beck, Marcus (Author) , Zips, Daniel (Author) , Li, Yimin (Author) , Lin, Qin (Author) , Amthauer, Holger (Author) , Troost, Esther G. C. (Author) , van den Hoff, Jörg (Author) , Budach, Volker (Author) , Kotzerke, Jörg (Author) , Ferentinos, Konstantinos (Author) , Karagiannis, Efstratios (Author) , Kaul, David (Author) , Gregoire, Vincent (Author) , Holzgreve, Adrien (Author) , Albert, Nathalie L. (Author) , Nikulin, Pavel (Author) , Bachmann, Michael (Author) , Kopka, Klaus (Author) , Krause, Mechthild (Author) , Baumann, Michael (Author) , Kazmierska, Joanna (Author) , Cegla, Paulina (Author) , Cholewinski, Witold (Author) , Strouthos, Iosif (Author) , Zöphel, Klaus (Author) , Majchrzak, Ewa (Author) , Landry, Guillaume (Author) , Belka, Claus (Author) , Stromberger, Carmen (Author) , Hofheinz, Frank (Author)
Format: Article (Journal)
Language:English
Published: 08 June 2022
In: Frontiers in oncology
Year: 2022, Volume: 12, Pages: 1-11
ISSN:2234-943X
DOI:10.3389/fonc.2022.870319
Online Access:Resolving-System, lizenzpflichtig, Volltext: https://doi.org/10.3389/fonc.2022.870319
Verlag, lizenzpflichtig, Volltext: https://www.frontiersin.org/articles/10.3389/fonc.2022.870319
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Author Notes:Sebastian Zschaeck, Julian Weingärtner, Elia Lombardo, Sebastian Marschner, Marina Hajiyianni, Marcus Beck, Daniel Zips, Yimin Li, Qin Lin, Holger Amthauer, Esther G.C. Troost, Jörg van den Hoff, Volker Budach, Jörg Kotzerke, Konstantinos Ferentinos, Efstratios Karagiannis, David Kaul, Vincent Gregoire, Adrien Holzgreve, Nathalie L. Albert, Pavel Nikulin, Michael Bachmann, Klaus Kopka, Mechthild Krause, Michael Baumann, Joanna Kazmierska, Paulina Cegla, Witold Cholewinski, Iosif Strouthos, Klaus Zöphel, Ewa Majchrzak, Guillaume Landry, Claus Belka, Carmen Stromberger and Frank Hofheinz
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Summary:Purpose18F-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.MethodsOriginal 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 SUVmax, SUVmean, 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).ResultsFDG-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) SUVmax was well suited to identify patients with excellent LRC for organ preservation. Patients with SUVmax 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.ConclusionFDG-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.
Item Description:Gesehen am 09.08.2022
Physical Description:Online Resource
ISSN:2234-943X
DOI:10.3389/fonc.2022.870319

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