Maximal standard uptake values of 18F-fluoro-2-deoxy-D-glucose positron emission tomography compared with Epstein-Barr virus DNA as prognostic indicators in de novo metastatic nasopharyngeal carcinoma patients

Xue-Song Sun,Hao-Jun Xie,Qing-Nan Tang,Shan-Shan Guo,Yu-Jing Liang,Sai-Lan Liu,Jin-Jie Yan,Li-Ting Liu,Lin-Quan Tang,Hai-Qiang Mai,Xiao-Yun Li,Yue-Feng Wen,Qiu-Yan Chen

doi:10.1186/s12885-019-6106-2

Xue-Song Sun, Hao-Jun Xie + Show 11 more

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https://doi.org/10.1186/s12885-019-6106-2

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Abstract

BackgroundThis study aimed to evaluate the prognostic value of maximal standard uptake values (SUVmax) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (PET) comparing with Epstein-Barr virus (EBV) DNA levels in de novo metastatic nasopharyngeal carcinoma (NPC) patients.MethodsFrom December 2006 to December 2016, 253 de novo metastatic NPC patients assessed by PET/ computed tomography were involved in current study. SUVmax-T, SUVmax-N, and SUVmax-M referred to the SUVmax at the primary tumor, cervical lymph nodes, and metastatic lesions respectively. Overall survival (OS) was the primary endpoint.ResultPatients who died during the follow-up had significantly higher SUVmax-N, SUVmax-M, and EBV DNA level than those in the patients who were alive. SUVmax-N and SUVmax-M were positively correlated with EBV DNA level. The cut-off values of SUVmax-T, SUVmax-N, SUVmax-M, and EBV DNA were 17.0, 12.7, and 6.9, and 13,800 copies/mL respectively, which were determined by receiver operating characteristic (ROC) curve analysis. Patients with elevated SUVmax-N, SUVmax-M, and EBV DNA levels had a lower 3-year OS rate. In multivariate analysis, the independent prognostic factors of OS included EBV DNA, metastatic site, and locoregional radiotherapy application, while SUVmax was not an independent prognostic factor.ConclusionIn de novo metastatic NPC patients, higher SUVmax-N and SUVmax-M were associated with worse prognosis. However, the predictive ability of SUVmax-N and SUVmax-M was poorer than that of EBV DNA.

Highlights

This study aimed to evaluate the prognostic value of maximal standard uptake values (SUVmax) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (PET) comparing with Epstein-Barr virus (EBV) DNA levels in de novo metastatic nasopharyngeal carcinoma (NPC) patients
In de novo metastatic NPC patients, higher Maximal standard uptake value (SUVmax)-N and SUVmax-M were associated with worse prognosis
The inclusion criteria were as follows: (1) histologically confirmed NPC; (2) evidence of distant metastasis assessed by PET/Computed tomography (CT); (3) use of cisplatinbased palliative chemotherapy (PCT); (4) an initial Karnofsky performance score of > 70; (5) adequate renal and hepatic functions; and (6) no pregnancy, lactation, or second malignant disease

Summary

Introduction

This study aimed to evaluate the prognostic value of maximal standard uptake values (SUVmax) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (PET) comparing with Epstein-Barr virus (EBV) DNA levels in de novo metastatic nasopharyngeal carcinoma (NPC) patients. Nasopharyngeal carcinoma (NPC) is a unique malignancy, which has distinguishing features from other head and neck cancer in terms of epidemiology, geographic areas, population, and prognosis. In 2012, approximately 86,700 new cases of NPC were reported, accounting for 0.6% of all cancers and causing 50,800 deaths [1, 2]. NPC is sensitive to both radiation and chemotherapy. Owing to great improvements in both diagnosis and radiation techniques, the prognosis of patients with non-metastatic NPC is quite satisfactory nowadays and the overall survival exceeds 80% [5]

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