Low value of whole-body dual-modality [18f]fluorodeoxyglucose positron emission tomography/computed tomography in primary staging of stage I-II nasopharyngeal carcinoma: a nest case-control study

被引:8
作者
Xiao, Bei-Bei [1 ,2 ]
Chen, Qiu-Yan [1 ,2 ]
Sun, Xue-Song [1 ,2 ]
Li, Ji-Bin [1 ,3 ]
Luo, Dong-hua [1 ,2 ]
Sun, Rui [1 ,2 ]
Lin, Da-Feng [1 ,2 ]
Zhang, Xu [1 ,4 ]
Fan, Wei [1 ,4 ]
Lv, Xiao-Fei [1 ,5 ]
Han, Lu-Jun [1 ,5 ]
Wen, Yue-Feng [1 ,2 ]
Yuan, Li [1 ]
Guo, Shan-Shan [1 ,2 ]
Liu, Li-Ting [1 ,2 ]
Liu, Sai-Lan [1 ,2 ]
Tang, Qing-Nan [1 ,2 ]
Liang, Yu-Jing [1 ,2 ]
Li, Xiao-Yun [1 ,2 ]
Lin, Chao [1 ,2 ]
Guo, Ling [1 ,2 ]
Mai, Hai-Qiang [1 ,2 ]
Tang, Lin-Quan [1 ,2 ]
机构
[1] Sun Yat Sen Univ, State Key Lab Oncol South China, Guangdong Key Lab Nasopharyngeal Carcinoma Diag &, Canc Ctr,Collaborat Innovat Ctr Canc Med, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China
[2] Sun Yat Sen Univ, Canc Ctr, Dept Nasopharyngeal Carcinoma, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China
[3] Sun Yat Sen Univ, Canc Ctr, Dept Clin Res, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China
[4] Sun Yat Sen Univ, Canc Ctr, Dept Nucl Med, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China
[5] Sun Yat Sen Univ, Canc Ctr, Dept Med Imaging, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China
基金
中国国家自然科学基金; 国家重点研发计划;
关键词
Nasopharyngeal carcinoma; PET/CT; MRI; Neoplasm staging; INTENSITY-MODULATED RADIOTHERAPY; F-18-FDG PET; DISTANT METASTASIS; NODE METASTASES; NECK; HEAD; CRITERIA; DNA; CT;
D O I
10.1007/s00330-020-07478-1
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
Objectives The value of using PET/CT for staging of stage I-II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy. Methods A total of 1003 patients with pathologically confirmed NPC of stages I-II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node metastasis was defined by the change of size according to follow-up MRI. The diagnostic efficacies were compared in 218 patients who underwent both PET/CT and CWU. After covariate adjustment using propensity scoring, a cohort of 872 patients (218 with and 654 without pre-treatment PET/CT) was included. The primary outcome was overall survival based on intention to treat. Results Retropharyngeal lymph nodes were metastatic based on follow-up MRI in 79 cases. PET/CT was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions (72.2% [62.3-82.1] vs. 91.1% [84.8-97.4], p = 0.004). Neck lymph nodes were metastatic in 89 cases and PET/CT was more sensitive than MRI (96.6% [92.8-100.0] vs. 76.4% [67.6-85.2], p < 0.001). In the survival analyses, there was no association between pre-treatment PET/CT use and improved overall survival, progression-free survival, local relapse-free survival, regional relapse-free survival, and distant metastasis-free survival. Conclusions This study showed PET/CT is of little value for staging of stage I-II NPC patients at initial imaging.
引用
收藏
页码:5222 / 5233
页数:12
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