FDG volumetric parameters and survival outcomes after definitive chemoradiotherapy in patients with recurrent head and neck squamous cell carcinoma

Vasavi Paidpally, Alin Chirindel, Christine H. Chung, Jeremy Richmon, Wayne Koch, Harry Quon, Rathan M. Subramaniam

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to establish the predictive value of 18F-FDG parameters for overall survival in biopsy-proven recurrent head and neck squamous cell cancer (HNSCC) patients after definitive chemoradiotherapy. MATERIALS AND METHODS. We conducted a retrospective study including 34 patients with HNSCC who had biopsy-proven recurrence between April 2004 and March 2012 and underwent FDG PET/CT at our institution at the time of recurrence. Maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. The primary outcome measure was overall survival. ROC analysis, univariate and multivariate Cox regression models, and Kaplan-Meir survival curves were performed. RESULTS. In univariate analyses, human papillomavirus (HPV) status (p = 0.04), primary site recurrence of MTV (p = 0.03), metastasis of MTV (p = 0.02), metastasis of TLG (p = 0.02), total MTV (p = 0.002), and total TLG (p = 0.04) were significantly associated with overall survival outcome. Total MTV remained as significant independent prognostic factor when adjusted for all other covariates except for primary site recurrence SUVmax and SUVpeak and lymph node SUVmax and SUVpeak. There was a significant difference in time to survival between patients with total MTV above and below the 50th percentile (Mantel-Cox log-rank test, p = 0.05 and Gehan-Breslow-Wilcoxon test, p = 0.03) and the optimum threshold of 16.8 mL (Mantel-Cox log-rank test, p = 0.01 and Gehan-Breslow-Wilcoxon test, p = 0.01; hazard ratio [HR], 0.25). CONCLUSION. FDG PET/CT-based total MTV and clinical HPV status may be significant prognostic markers for overall survival of patients with recurrent HNSCC after definitive chemoradiotherapy.

Original languageEnglish (US)
JournalAmerican Journal of Roentgenology
Volume203
Issue number2
DOIs
StatePublished - Jan 1 2014

Fingerprint

Chemoradiotherapy
Tumor Burden
Survival
Squamous Cell Neoplasms
Glycolysis
Head and Neck Neoplasms
Recurrence
Head
Neoplasm Metastasis
Biopsy
Fluorodeoxyglucose F18
Carcinoma, squamous cell of head and neck
Proportional Hazards Models
ROC Curve
Retrospective Studies
Lymph Nodes
Outcome Assessment (Health Care)

Keywords

  • Head and neck squamous cell carcinoma recurrence
  • Human papillomavirus
  • Metabolic tumor volume

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

FDG volumetric parameters and survival outcomes after definitive chemoradiotherapy in patients with recurrent head and neck squamous cell carcinoma. / Paidpally, Vasavi; Chirindel, Alin; Chung, Christine H.; Richmon, Jeremy; Koch, Wayne; Quon, Harry; Subramaniam, Rathan M.

In: American Journal of Roentgenology, Vol. 203, No. 2, 01.01.2014.

Research output: Contribution to journalArticle

Paidpally, Vasavi ; Chirindel, Alin ; Chung, Christine H. ; Richmon, Jeremy ; Koch, Wayne ; Quon, Harry ; Subramaniam, Rathan M. / FDG volumetric parameters and survival outcomes after definitive chemoradiotherapy in patients with recurrent head and neck squamous cell carcinoma. In: American Journal of Roentgenology. 2014 ; Vol. 203, No. 2.
@article{edb431c1b40d44a2a37c80bfc28e866e,
title = "FDG volumetric parameters and survival outcomes after definitive chemoradiotherapy in patients with recurrent head and neck squamous cell carcinoma",
abstract = "OBJECTIVE. The purpose of this study was to establish the predictive value of 18F-FDG parameters for overall survival in biopsy-proven recurrent head and neck squamous cell cancer (HNSCC) patients after definitive chemoradiotherapy. MATERIALS AND METHODS. We conducted a retrospective study including 34 patients with HNSCC who had biopsy-proven recurrence between April 2004 and March 2012 and underwent FDG PET/CT at our institution at the time of recurrence. Maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. The primary outcome measure was overall survival. ROC analysis, univariate and multivariate Cox regression models, and Kaplan-Meir survival curves were performed. RESULTS. In univariate analyses, human papillomavirus (HPV) status (p = 0.04), primary site recurrence of MTV (p = 0.03), metastasis of MTV (p = 0.02), metastasis of TLG (p = 0.02), total MTV (p = 0.002), and total TLG (p = 0.04) were significantly associated with overall survival outcome. Total MTV remained as significant independent prognostic factor when adjusted for all other covariates except for primary site recurrence SUVmax and SUVpeak and lymph node SUVmax and SUVpeak. There was a significant difference in time to survival between patients with total MTV above and below the 50th percentile (Mantel-Cox log-rank test, p = 0.05 and Gehan-Breslow-Wilcoxon test, p = 0.03) and the optimum threshold of 16.8 mL (Mantel-Cox log-rank test, p = 0.01 and Gehan-Breslow-Wilcoxon test, p = 0.01; hazard ratio [HR], 0.25). CONCLUSION. FDG PET/CT-based total MTV and clinical HPV status may be significant prognostic markers for overall survival of patients with recurrent HNSCC after definitive chemoradiotherapy.",
keywords = "Head and neck squamous cell carcinoma recurrence, Human papillomavirus, Metabolic tumor volume",
author = "Vasavi Paidpally and Alin Chirindel and Chung, {Christine H.} and Jeremy Richmon and Wayne Koch and Harry Quon and Subramaniam, {Rathan M.}",
year = "2014",
month = "1",
day = "1",
doi = "10.2214/AJR.13.11654",
language = "English (US)",
volume = "203",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "2",

}

TY - JOUR

T1 - FDG volumetric parameters and survival outcomes after definitive chemoradiotherapy in patients with recurrent head and neck squamous cell carcinoma

AU - Paidpally, Vasavi

AU - Chirindel, Alin

AU - Chung, Christine H.

AU - Richmon, Jeremy

AU - Koch, Wayne

AU - Quon, Harry

AU - Subramaniam, Rathan M.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - OBJECTIVE. The purpose of this study was to establish the predictive value of 18F-FDG parameters for overall survival in biopsy-proven recurrent head and neck squamous cell cancer (HNSCC) patients after definitive chemoradiotherapy. MATERIALS AND METHODS. We conducted a retrospective study including 34 patients with HNSCC who had biopsy-proven recurrence between April 2004 and March 2012 and underwent FDG PET/CT at our institution at the time of recurrence. Maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. The primary outcome measure was overall survival. ROC analysis, univariate and multivariate Cox regression models, and Kaplan-Meir survival curves were performed. RESULTS. In univariate analyses, human papillomavirus (HPV) status (p = 0.04), primary site recurrence of MTV (p = 0.03), metastasis of MTV (p = 0.02), metastasis of TLG (p = 0.02), total MTV (p = 0.002), and total TLG (p = 0.04) were significantly associated with overall survival outcome. Total MTV remained as significant independent prognostic factor when adjusted for all other covariates except for primary site recurrence SUVmax and SUVpeak and lymph node SUVmax and SUVpeak. There was a significant difference in time to survival between patients with total MTV above and below the 50th percentile (Mantel-Cox log-rank test, p = 0.05 and Gehan-Breslow-Wilcoxon test, p = 0.03) and the optimum threshold of 16.8 mL (Mantel-Cox log-rank test, p = 0.01 and Gehan-Breslow-Wilcoxon test, p = 0.01; hazard ratio [HR], 0.25). CONCLUSION. FDG PET/CT-based total MTV and clinical HPV status may be significant prognostic markers for overall survival of patients with recurrent HNSCC after definitive chemoradiotherapy.

AB - OBJECTIVE. The purpose of this study was to establish the predictive value of 18F-FDG parameters for overall survival in biopsy-proven recurrent head and neck squamous cell cancer (HNSCC) patients after definitive chemoradiotherapy. MATERIALS AND METHODS. We conducted a retrospective study including 34 patients with HNSCC who had biopsy-proven recurrence between April 2004 and March 2012 and underwent FDG PET/CT at our institution at the time of recurrence. Maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. The primary outcome measure was overall survival. ROC analysis, univariate and multivariate Cox regression models, and Kaplan-Meir survival curves were performed. RESULTS. In univariate analyses, human papillomavirus (HPV) status (p = 0.04), primary site recurrence of MTV (p = 0.03), metastasis of MTV (p = 0.02), metastasis of TLG (p = 0.02), total MTV (p = 0.002), and total TLG (p = 0.04) were significantly associated with overall survival outcome. Total MTV remained as significant independent prognostic factor when adjusted for all other covariates except for primary site recurrence SUVmax and SUVpeak and lymph node SUVmax and SUVpeak. There was a significant difference in time to survival between patients with total MTV above and below the 50th percentile (Mantel-Cox log-rank test, p = 0.05 and Gehan-Breslow-Wilcoxon test, p = 0.03) and the optimum threshold of 16.8 mL (Mantel-Cox log-rank test, p = 0.01 and Gehan-Breslow-Wilcoxon test, p = 0.01; hazard ratio [HR], 0.25). CONCLUSION. FDG PET/CT-based total MTV and clinical HPV status may be significant prognostic markers for overall survival of patients with recurrent HNSCC after definitive chemoradiotherapy.

KW - Head and neck squamous cell carcinoma recurrence

KW - Human papillomavirus

KW - Metabolic tumor volume

UR - http://www.scopus.com/inward/record.url?scp=84906495664&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906495664&partnerID=8YFLogxK

U2 - 10.2214/AJR.13.11654

DO - 10.2214/AJR.13.11654

M3 - Article

C2 - 25055289

AN - SCOPUS:84906495664

VL - 203

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 2

ER -