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PLoS One. 2018 Aug 16;13(8):e0200823. doi: 10.1371/journal.pone.0200823. eCollection 2018.

Early metabolic 18F-FDG PET/CT response of locally advanced squamous-cell carcinoma of head and neck to induction chemotherapy: A prospective pilot study.

Author information

1
Medical Oncology Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
2
Imaging Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
3
Pathology Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
4
Biostatistics Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
5
Radiotherapy Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
6
Head and Neck Surgery Department, A.C. Camargo Cancer Center, São Paulo, Brazil.

Abstract

OBJECTIVE:

The objective of this study was to assess the clinical value of 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) after the first cycle of induction chemotherapy (IC) in locally advanced squamous cell carcinoma of the head and neck (LASCCHN).

METHODS AND FINDINGS:

A prospective, single-arm, single center study was performed, with patients enrolled between February 2010 and July 2013.Patients (n = 49) with stage III/IVA-B LASCCHN who underwent IC with taxanes, cisplatin, and fluorouracil were recruited. Staging procedures included loco-regional and chest imaging, endoscopic examination, and PET/CT scan. On day 14 of the first cycle, a second PET/CT scan was performed. Patients with no early increase in regional lymph node maximum 18F-FDG standard uptake value (SUV), detected using 18F-FDG PET/CT after first IC had better progression-free survival (hazard ratio (HR) = 0.18, 95%, confidence interval (CI) 0.056-0.585; p = 0.004) and overall survival (HR = 0.14, 95% CI 0.040-0.498; p = 0.002), and were considered responders. In this subgroup, patients who achieved a reduction of ≥ 45% maximum primary tumor SUV experienced improved progression-free (HR = 0.23, 95% CI 0.062-0.854; p = 0.028) and overall (HR = 0.11, 95% CI 0.013-0.96; p = 0.046) survival.

CONCLUSIONS:

These results suggest a potential role for early response evaluation with PET/CT examination in patients with LASCCHN undergoing IC. Increased regional lymph node maximum SUV and insufficient decrease in primary tumor uptake predict poorer outcomes.

PMID:
30114190
PMCID:
PMC6095513
DOI:
10.1371/journal.pone.0200823
[Indexed for MEDLINE]
Free PMC Article

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