We investigated the prognostic values of pre-treatment (18)F-fluorodeoxyglucose positron emission tomography (PET) scan on patients with squamous cell carcinoma of the head and neck (SCCHN).
From August 2011 to May 2014, eighty-one patients with previously untreated, biopsy-proven, stage III-IV SCCHN were enrolled. They received a uniform outpatient weekly docetaxel-based induction chemotherapy followed by local treatment (either radiotherapy or surgery). Quantitative parameters of pre-treatment PET scan were collected, including the maximum standardized uptake value (SUVmax) of the primary tumor, the metabolic tumor volume (MTV) and the total lesion glycolysis (TLG). The receiver operating characteristic curves method was used to determine the best cut-off values (14 for SUVmax, 85 for MTV, and 305 for TLG, respectively).
After a median follow-up of 26 months, locoregional recurrence and distant metastasis were observed in 19 and 6 patients. There were 24 deaths. The 2-year overall survival rates were 65% and 90% for patients with SUVmax ≧ and < 14, respectively (HR, 2.84; 95% CI, 1.12 to 7.21; P = 0.028). MTV (62% vs. 82%, HR, 2.94; 95% CI, 1.29 to 6.70; P = 0.01) and TLG (65% vs. 85%, HR, 3.69; 95% CI, 1.45 to 9.39; P = 0.006) showed similar outcome. Multivariate Cox analysis also demonstrated the same results.
The SUVmax, MTV, and TLG of the pre-treatment PET scan are independent predictors of overall survival in patients with advanced SCCHN receiving docetaxel-based induction chemotherapy.
Clinical trial identification
All authors have declared no conflicts of interest.