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research article

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

Castelli, Joel
•
Depeursinge, A.  
•
Devillers, A.
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March 1, 2019
European Journal Of Nuclear Medicine And Molecular Imaging

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.

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Type
research article
DOI
10.1007/s00259-018-4134-9
Web of Science ID

WOS:000457151600011

Author(s)
Castelli, Joel
•
Depeursinge, A.  
•
Devillers, A.
•
Campillo-Gimenez, B.
•
Dicente, Y.
•
Prior, J. O.
•
Chajon, E.
•
Jegoux, F.
•
Sire, C.
•
Acosta, O.
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Date Issued

2019-03-01

Publisher

SPRINGER

Published in
European Journal Of Nuclear Medicine And Molecular Imaging
Volume

46

Issue

3

Start page

638

End page

649

Subjects

Radiology, Nuclear Medicine & Medical Imaging

•

Radiology, Nuclear Medicine & Medical Imaging

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head and neck cancer

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nomogram

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prognostic score

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pet

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radiotherapy

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metabolic tumor volume

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squamous-cell carcinoma

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locally advanced head

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mucosal primary head

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fdg pet

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radiation-therapy

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f-18-fdg pet/ct

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human-papillomavirus

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concomitant chemotherapy

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risk stratification

Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
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Available on Infoscience
June 18, 2019
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/158064
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