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The role of interim FDG-PET after induction chemotherapy as a prediction of the efficacy of concurrent chemoradiotherapy in locally advanced squamous carcinoma of the head and neck

Date

09 Oct 2016

Session

Poster display

Presenters

Ka-Rham Kim

Citation

Annals of Oncology (2016) 27 (6): 328-350. 10.1093/annonc/mdw376

Authors

K. Kim1, H. Shim2, J. Hwang2, S. Cho2, I. Chung2, S.Y. Kwon3, W. Bae2

Author affiliations

  • 1 Hemato-oncology, Chonnam National University Hwasun Hospital, 58128 - Hwasun-Gun/KR
  • 2 Hemato-oncology, Chonnam National University Hwasun Hospital, Hwasun-Gun/KR
  • 3 Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun-Gun/KR
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Resources

Abstract 3001

Background

Having advantage for organ preservation and systemic control, induction chemotherapy (ICT) using docetaxel, cisplatin and 5-FU (DCF) followed concurrent chemoradiotherapy (CCRT) has been used for nonsurgical management of locally advanced head and neck squamous cell carcinoma (HNSCC). Early prediction of efficacy of CCRT could be helpful to select patients with more effective in surgery than CCRT. We evaluated the role of interim 18-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) after ICT as a prediction of the efficacy of CCRT and clinical outcomes.

Methods

Tumor responses were retrospectively reviewed based on Response Evaluation Criteria in Solid Tumors after ICT and CCRT in locally advanced HNSCC. FDG-PET/CT scans were performed in all patients before and after three cycles of DCF. We examined the association of metabolic response by the percentage decrease of maximum standardized uptake value (SUVmax) after ICT with complete response (CR) to CCRT and clinical outcomes including progression-free survival (PFS) and overall survival (OS).

Results

Forty-four patients with locally advanced HNSCC were evaluated with a median follow-up of 31.7 months. The SUVmax after ICT from baseline was more decreased in CR to CCRT group than non-CR group (78.8% vs. 62.5%, p = 0.004). A 78% decrease of SUVmax after ICT from baseline predicted CR after CCRT (59.3% vs. 17.6%, p = 0.012), PFS (median, not reached vs. 15.0 months, p = 0.002) and OS (median, not reached vs. 43.3 months, p = 0.005) of the patients.

Conclusions

The SUVmax on interim FDG-PET after ICT could be useful to select patients benefitting from CCRT in locally advanced HNSCC and to predict survival outcomes.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

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