Early restaging whole-body 18F-FDG PET during induction chemotherapy predicts clinical outcome in patients with locoregionally advanced nasopharyngeal carcinoma

Ruoh Fang Yen, Tony Hsiu Hsi Chen, Lai Lei Ting, Kai Yuan Tzen, Mei Hsiu Pan, Ruey Long Hong

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: This study was undertaken to evaluate the utility of whole-body 18F-FDG PET in monitoring therapeutic effect during induction chemotherapy (IC) and in predicting prognosis in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). Methods: Fifty patients who had histologically proven, locoregionally advanced NPC without distant metastasis and had received IC were recruited in this study. The study cohort consisted of 19 females and 31 males (age 17-72 years, mean 45.9±11.9). Whole-body 18F-FDG PET was performed in each patient after completion of one (33 patients) or two (17 patients) courses of IC. Each patient was restaged on the basis of the 18F-FDG PET results. Patients who were downstaged to stage I or II were classified as major responders; the rest were classified as non-major responders. Results: Only 1 of the 23 major responders subsequently developed local recurrence. At the time of data analysis, all major responders were alive; by contrast, of the 27 non-major responders, 15 had locoregional recurrence or distant metastasis and nine had died (seven of NPC and two of treatment-related complications). Kaplan-Meier survival analysis showed significantly longer recurrence-free survival and overall survival in major responders (56.4±9.2 and 58.1±2.2 months) as compared with non-major responders (33.7±23.2 and 44.7±20.0 months), with p<0.0001 and p=0.0024, respectively. Conclusion: The results of this study suggest that early restaging by a single whole-body 18F-FDG PET scan after the first or second course of IC is useful for predicting therapeutic response and outcome in patients with locoregionally advanced NPC.

Original languageEnglish
Pages (from-to)1152-1159
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume32
Issue number10
DOIs
Publication statusPublished - Oct 1 2005
Externally publishedYes

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Induction Chemotherapy
Fluorodeoxyglucose F18
Recurrence
Neoplasm Metastasis
Survival
Nasopharyngeal carcinoma
Kaplan-Meier Estimate
Therapeutic Uses
Survival Analysis
Positron-Emission Tomography
Cohort Studies
Therapeutics

Keywords

  • Induction chemotherapy
  • Nasopharyngeal carcinoma
  • Survival analysis
  • Therapeutic response
  • Whole-body F-FDG PET

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Early restaging whole-body 18F-FDG PET during induction chemotherapy predicts clinical outcome in patients with locoregionally advanced nasopharyngeal carcinoma. / Yen, Ruoh Fang; Chen, Tony Hsiu Hsi; Ting, Lai Lei; Tzen, Kai Yuan; Pan, Mei Hsiu; Hong, Ruey Long.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 32, No. 10, 01.10.2005, p. 1152-1159.

Research output: Contribution to journalArticle

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abstract = "Purpose: This study was undertaken to evaluate the utility of whole-body 18F-FDG PET in monitoring therapeutic effect during induction chemotherapy (IC) and in predicting prognosis in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). Methods: Fifty patients who had histologically proven, locoregionally advanced NPC without distant metastasis and had received IC were recruited in this study. The study cohort consisted of 19 females and 31 males (age 17-72 years, mean 45.9±11.9). Whole-body 18F-FDG PET was performed in each patient after completion of one (33 patients) or two (17 patients) courses of IC. Each patient was restaged on the basis of the 18F-FDG PET results. Patients who were downstaged to stage I or II were classified as major responders; the rest were classified as non-major responders. Results: Only 1 of the 23 major responders subsequently developed local recurrence. At the time of data analysis, all major responders were alive; by contrast, of the 27 non-major responders, 15 had locoregional recurrence or distant metastasis and nine had died (seven of NPC and two of treatment-related complications). Kaplan-Meier survival analysis showed significantly longer recurrence-free survival and overall survival in major responders (56.4±9.2 and 58.1±2.2 months) as compared with non-major responders (33.7±23.2 and 44.7±20.0 months), with p<0.0001 and p=0.0024, respectively. Conclusion: The results of this study suggest that early restaging by a single whole-body 18F-FDG PET scan after the first or second course of IC is useful for predicting therapeutic response and outcome in patients with locoregionally advanced NPC.",
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AU - Chen, Tony Hsiu Hsi

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AU - Tzen, Kai Yuan

AU - Pan, Mei Hsiu

AU - Hong, Ruey Long

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