Abstract
PurposeTo evaluate the predictive and prognostic value of pretreatment metabolic tumor volume (MTV) in patients with treated by radiotherapy (RT) or concurrent chemoradiotherapy (CCRT).MethodsWe reviewed the records of 118 patients with newly diagnosed laryngeal carcinoma, who had been treated by RT or CCRT. Pretreatment positron emission tomography (PET) was performed, and MTV values were obtained by contouring margins of standardized uptake value. Clinical factors and MTV were analyzed for their association with survival.ResultsPatients with residual disease showed a significantly higher MTV than those with a complete response (CR) after primary treatment. Univariate analysis showed that the patients with a high MTV had a significantly lower disease-free survival (DFS) (p < 0.001). Subsite (p = 0.010), T-stage (p < 0.001), nodal metastasis (p < 0.001) and clinical stage (p < 0.001) also correlated significantly with DFS. In the multivariate analysis, MTV and clinical stage were both found to be independent prognostic factors for DFS (p = 0.001, p = 0.034, respectively). The 3-year DFS for patients with a high MTV were significantly poorer than those with a low MTV (p < 0.001).ConclusionsMTV of the primary tumor is a significant prognostic factor for DFS in patients with laryngeal carcinoma treated by RT or CCRT. The results imply that MTV could be an important factor when planning treatment and follow-up for patients with laryngeal carcinoma.
Highlights
Surgery and subsequent radiation therapy (RT) has become the treatment of choice for early and locally advanced head and neck cancer
Univariate analysis showed that the patients with a high metabolic tumor volume (MTV) had a significantly lower disease-free survival (DFS) (p < 0.001)
MTV of the primary tumor is a significant prognostic factor for DFS in patients with laryngeal carcinoma treated by RT or concurrent chemoradiotherapy (CCRT)
Summary
Surgery and subsequent radiation therapy (RT) has become the treatment of choice for early and locally advanced head and neck cancer. In patients with laryngeal cancer, phonetic function is sacrificed when surgical resection is performed. RT is, used for the purpose of functional preservation, and concurrent chemotherapy is added with the intention of controlling micrometastasis and/or to act as a radiosensitizers [1]. Patients sometimes experience a residual or recurrent tumor after RT or concurrent chemoradiotherapy (CCRT), and salvage surgery for these patients can result in an increased risk of perioperative complications. For this reason, precise prediction of the response to RT or CCRT is important when selecting the optimal treatment strategy. The prognostic value of these staging systems is limited as they are based on tumor morphology, not on individual biological and molecular characteristics [2]
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