PET-based prognostic survival model after radiotherapy for head and neck cancer

被引:14
作者
Castelli, Joel [1 ,2 ,3 ]
Depeursinge, A. [4 ,5 ]
Devillers, A. [6 ]
Campillo-Gimenez, B. [2 ,3 ,7 ]
Dicente, Y. [4 ,8 ]
Prior, J. O. [9 ]
Chajon, E. [1 ]
Jegoux, F. [10 ]
Sire, C. [11 ]
Acosta, O. [2 ,3 ]
Gherga, E. [12 ]
Sun, X. [12 ,13 ]
De Bari, B. [13 ]
Bourhis, J. [14 ]
de Crevoisier, R. [1 ,2 ,3 ]
机构
[1] Canc Inst Eugene Marquis, Dept Radiotherapy, F-35000 Rennes, France
[2] INSERM, U1099, F-35000 Rennes, France
[3] Univ Rennes 1, LTSI, F-35000 Rennes, France
[4] Ecole Polytech Fed Lausanne, CH-1015 Lausanne, VD, Switzerland
[5] Univ Appl Sci Western Switzerland, CH-3960 Sierre, Switzerland
[6] Canc Inst Eugene Marquis, Dept Nucl Med, F-35000 Rennes, France
[7] Canc Inst Eugene Marquis, Clin Res Direct, F-35000 Rennes, France
[8] Univ Geneva, CH-1211 Geneva, Switzerland
[9] Lausanne Univ Hosp, Nucl Med & Mol Imaging Dept, Lausanne, Switzerland
[10] CHU Rennes, Head & Neck Dept, F-35000 Rennes, France
[11] Lorient Hosp, Dept Radiotherapy, F-56100 Lorient, France
[12] CHU Besancon, Dept Radiotherapy, Besancon, France
[13] Hop Nord Franche Comte Montbeliard, Dept Radiotherapy, Montbeliard, France
[14] Lausanne Univ Hosp, Dept Radiotherapy, Lausanne, Switzerland
基金
瑞士国家科学基金会;
关键词
Head and neck cancer; Nomogram; Prognostic score; PET; Radiotherapy; METABOLIC TUMOR VOLUME; SQUAMOUS-CELL CARCINOMA; LOCALLY ADVANCED HEAD; MUCOSAL PRIMARY HEAD; FDG PET; RADIATION-THERAPY; F-18-FDG PET/CT; HUMAN-PAPILLOMAVIRUS; CONCOMITANT CHEMOTHERAPY; RISK STRATIFICATION;
D O I
10.1007/s00259-018-4134-9
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PurposeThe aims of this multicentre retrospective study of locally advanced head and neck cancer (LAHNC) treated with definitive radiotherapy were to (1) identify positron emission tomography (PET)-F-18-fluorodeoxyglucose (F-18-FDG) parameters correlated with overall survival (OS) in a training cohort, (2) compute a prognostic model, and (3) externally validate this model in an independent cohort.Materials and methodsA total of 237 consecutive LAHNC patients divided into training (n=127) and validation cohorts (n=110) were retrospectively analysed. The following PET parameters were analysed: SUVMax, metabolic tumour volume (MTV), total lesion glycolysis (TLG), and SUVMean for the primary tumour and lymph nodes using a relative SUVMax threshold or an absolute SUV threshold. Cox analyses were performed on OS in the training cohort. The c-index was used to identify the highly prognostic parameters. A prognostic model was subsequently identified, and a nomogram was generated. The model was externally tested in the validation cohort.ResultsIn univariate analysis, the significant PET parameters for the primary tumour included MTV (relative thresholds from 6 to 83% and absolute thresholds from 1.5 to 6.5) and TLG (relative thresholds from 1 to 82% and absolute thresholds from 0.5 to 4.5). For the lymph nodes, the significant parameters included MTV and TLG regardless of the threshold value. In multivariate analysis, tumour site, p16 status, MTV35% of the primary tumour, and MTV44% of the lymph nodes were independent predictors of OS. Based on these four parameters, a prognostic model was identified with a c-index of 0.72. The corresponding nomogram was generated. This prognostic model was externally validated, achieving a c-index of 0.66.ConclusionsA prognostic model of OS based on primary tumour and lymph node MTV, tumour site, and p16 status was proposed and validated. The corresponding nomogram may be used to tailor individualized treatment.
引用
收藏
页码:638 / 649
页数:12
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