The Predictive Value of Early Assessment After 1 Cycle of Induction Chemotherapy with 18F-FDG PET/CT and Diffusion-Weighted MRI for Response to Radical Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma.

Loading...
Thumbnail Image

Authors

Wong, KH
Panek, R
Welsh, L
Mcquaid, D
Dunlop, A
Riddell, A
Murray, I
Du, Y
Chua, S
Koh, D-M
Bhide, S
Nutting, C
Oyen, WJG
Harrington, K
Newbold, KL

Document Type

Journal Article

Date

2016-12-01

Date Accepted

2016-05-31

Date Available

Abstract

UNLABELLED: The objective of this study was to assess the predictive value of early assessment (after 1 cycle of induction chemotherapy [IC]) with 18F-FDG PET/CT and diffusion-weighted (DW) MRI for subsequent response to radical chemoradiotherapy in locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: Twenty patients with stage III-IVa HNSCC prospectively underwent 18F-FDG PET/CT and DW MRI before and 2 wk after each cycle of IC (first cycle, IC1; second cycle, IC2). Response was assessed 3 mo after completion of chemoradiotherapy with clinical examination, MRI, and 18F-FDG PET/CT. Patients with persistent disease were classed as nonresponders. Changes in functional and molecular imaging parameters after IC1 were compared between responders and nonresponders with the Mann-Whitney U test. The significance threshold was set at a P value of less than 0.05. RESULTS: Responders showed a significantly greater reduction in metabolic tumor volume (P = 0.03) and total lesion glycolysis (P = 0.04) after IC1 than nonresponders. Responders also showed a tendency toward a larger but statistically nonsignificant increase in apparent diffusion coefficient after IC1. There was no significant difference in the changes from baseline between the IC1 and IC2 for all functional and molecular imaging parameters, indicating that most biologic response to IC measured by 18F-FDG PET/CT and DW MRI was observed early after the first cycle of IC. CONCLUSION: Our preliminary data indicate that the 18F-FDG PET/CT-derived metabolic tumor volume or total lesion glycolysis, acquired after IC1, are early predictive biomarkers for ultimate response to subsequent chemoradiotherapy. These early biomarkers enable identification of patients at risk of treatment failure at an early time point, permitting treatment individualization and consideration of alternative strategies such as radiotherapy dose escalation or surgery.

Citation

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2016, 57 (12), pp. 1843 - 1850

Rights

Source Title

Publisher

SOC NUCLEAR MEDICINE INC

ISSN

0161-5505

eISSN

1535-5667

Research Team

Targeted Therapy
Translational Molecular Imaging

Notes