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Radiother Oncol. 2014 Jun;111(3):360-5. doi: 10.1016/j.radonc.2014.06.001. Epub 2014 Jun 30.

Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake.

Author information

1
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
2
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: ivan.storgaard.vogelius@rh.regionh.dk.
3
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark; Niels Bohr Institute, University of Copenhagen, Denmark.
4
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark; Department of Human Oncology, University of Wisconsin, Madison, United States; Greenebaum Cancer Center, Department of Epidemiology & Public Health, University of Maryland, Baltimore, United States.
5
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Denmark.
6
Niels Bohr Institute, University of Copenhagen, Denmark; Department of Science, Systems and Models, Roskilde University, Denmark.
7
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Denmark.

Abstract

BACKGROUND AND PURPOSE:

To analyze the recurrence pattern in relation to target volumes and (18)F-fluorodeoxyglucose (FDG) uptake on positron emission tomography in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive chemoradiation.

MATERIAL AND METHODS:

520 patients received radiotherapy for HNSCC from 2005 to 2009. Among 100 patients achieving complete clinical response and a later recurrence, 39 patients with 48 loco-regional failures had a recurrence CT scan before any salvage therapy. The estimated point of origin of each recurrence was transferred to the planning CT by deformable image co-registration. The recurrence position was then related to the delineated target volumes and iso-SUV-contours relative to the maximum standard uptake value (SUV). We defined the recurrence density as the total number of recurrences in a sub-volume divided by the sum of that volume for all patients.

RESULTS:

54% (95% CI 37-69%) of recurrences originated inside the FDG-positive volume and 96% (95% CI 86-99%) in the high dose region. Recurrence density was significantly higher in the central target volumes (P<0.0001) and increased with increasing FDG avidity (P=0.036).

CONCLUSIONS:

The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor.

KEYWORDS:

FDG-PET; Head and neck cancer; Pattern of failure; Radiotherapy; Recurrence

PMID:
24993331
PMCID:
PMC4469149
DOI:
10.1016/j.radonc.2014.06.001
[Indexed for MEDLINE]
Free PMC Article

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