Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Aug 1;74(5):1335-41.
doi: 10.1016/j.ijrobp.2008.10.060. Epub 2009 Mar 14.

Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer

Trang H La  1 , Edith J Filion, Brit B Turnbull, Jackie N Chu, Percy Lee, Khoa Nguyen, Peter Maxim, Andy Quon, Edward E Graves, Billy W Loo Jr, Quynh-Thu Le
Affiliations

Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer

Trang H La et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: To evaluate the prognostic value of metabolic tumor volume measured on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging and other clinical factors in patients treated for locally advanced head-and-neck cancer (HNC) at a single institution.

Materials and methods: Between March 2003 and August 2007, 85 patients received positron emission tomography (PET)/computed tomography-guided chemoradiotherapy for HNC. Metabolically active tumor regions were delineated on pretreatment PET scans semiautomatically using custom software. We evaluated the relationship of (18)F-fluorodeoxyglucose-PET maximum standardized uptake value (SUV) and total metabolic tumor volume (MTV) with disease-free survival (DFS) and overall survival (OS).

Results: Mean follow-up for surviving patients was 20.4 months. The estimated 2-year locoregional control, DFS, and OS for the group were 88.0%, 69.5%, and 78.4%, respectively. The median time to first failure was 9.8 months among the 16 patients with relapse. An increase in MTV of 17.4 mL (difference between the 75th and 25th percentiles) was significantly associated with an increased hazard of first event (recurrence or death) (1.9-fold, p < 0.001), even after controlling for Karnofsky performance status (KPS) (1.8-fold, p = 0.001), and of death (2.1-fold, p < 0.001). We did not find a significant relationship of maximum SUV, stage, or other clinical factors with DFS or OS.

Conclusions: Metabolic tumor volume is an adverse prognostic factor for disease recurrence and death in HNC. MTV retained significance after controlling for KPS, the only other significant adverse prognostic factor found in this cohort. MTV is a direct measure of tumor burden and is a potentially valuable tool for risk stratification and guiding treatment in future studies.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Primary site and regional nodal metabolic tumor volume. Maximum intensity projection views of 18F-fluorodeoxyglucose-positron emission tomography scans for two patients, with overlay of segmented metabolic tumor volumes (MTV). Figure 1a. Patient with Stage IVA oropharyngeal cancer (T3N2bM0) with small MTV (MTV: 63.3 ml, Progression free survival: 30.9 months). Figure 1b. A patient with Stage IVB (T4bN2cM0) oropharyngeal cancer with large MTV (MTV: 511.6 ml, Progression free survival: 13.8 months).
Figure 1
Figure 1
Primary site and regional nodal metabolic tumor volume. Maximum intensity projection views of 18F-fluorodeoxyglucose-positron emission tomography scans for two patients, with overlay of segmented metabolic tumor volumes (MTV). Figure 1a. Patient with Stage IVA oropharyngeal cancer (T3N2bM0) with small MTV (MTV: 63.3 ml, Progression free survival: 30.9 months). Figure 1b. A patient with Stage IVB (T4bN2cM0) oropharyngeal cancer with large MTV (MTV: 511.6 ml, Progression free survival: 13.8 months).
Figure 2
Figure 2
Disease-free and overall survival. Disease-free survival (DFS, dashed line) and overall survival (OS, solid line) for all 85 patients.
Figure 3
Figure 3
Disease-free survival by tertiles of metabolic tumor volume (MTV). PET = positron emission tomography.
Figure 4
Figure 4
Overall survival by tertiles of metabolic tumor volume (MTV). PET = positron emission tomography.
See this image and copyright information in PMC

References

    1. Wong RJ, Lin DT, Schoder H, et al. Diagnostic and prognostic value of [(18)F] fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma. J Clin Oncol. 2002;20:4199–4208. - PubMed
    1. Tucker R, Coel M, Ko J, et al. Impact of fluorine-18 fluorodeoxyglucose on patient management: First year’s experience in a clinical center. J Clin Oncol. 2001;19:2504–2508. - PubMed
    1. Laubenbacher C, Saumweber D, Wagner-Manslau C, et al. Comparison of fluorine-18-fluorodeoxyglucose PET, MRI and endoscopy for staging head and neck squamous cell carcinomas. J Nucl Med. 1995;36:1747–1757. - PubMed
    1. Schwartz DL, Ford E, Rajendran J, et al. FDG-PET/CT imaging for preradiotherapy staging of head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2003;57:129–136. - PubMed
    1. Minn H, Maria Lapela M, Klemi PJ. Prediction of Survival with Fluorine-18-Fluoro- deoxyglucose and PET in Head and Neck Cancer. J Nucl Med. 2007;38:1907–1911. - PubMed

Publication types

MeSH terms

Substances