Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients.

Abstract

e17521 Background: Nasopharyngeal carcinoma (NPC) is a special subtype of head and neck cancer (HNC), there is no highly specific prognostic parameters for NPC. Prognostic value of pretreatment 18F-PET-CT in NPC patient has controversial conclusion. Methods: The prospective and retrospective observational trails which used the 18F-FDG PET to predict the prognosis of the NPC patients were searched in MEDLINE, EMBASE, Cochrane library, CBM, CNKI and VIP (inception to July 2016). Two authors independently assessed study quality and extracted data. Event-free survival (EFS) was considered as the primary endpoint and overall survival rate (OS) was considered as the secondary endpoint. Results: 14 studies and 1,134 patients were included in our analysis. The HR (Hazard ratio) of SUVmax-T, MTV-T and TLG-T for EFS was 1.71 (95% CI, 1.02-2.86, p= 0.04), 2.38 (95%CI 1.53-3.70, p= 0.0001) and 1.65 (95%CI 0.76-3.59, p= 0.21) respectively. Among studies including TLG-T, those with a fixed SUV of 2.5 had an HR 3.55 (95% CI, 1.42–8.84, p= 0.007). The HR of SUVmax-T and MTV-T for OS was 2.19 (95%CI, 1.47-3.27, p= 0.0001) and 2.69 (95% CI, 1.01-7.17, p =0.05). Among studies including MTV-T, those with a fixed SUV of 2.5 had an HR of 4.07 (95% CI, 2.22–7.46, p< 0.00001). Test for predictive value of pretreatment SUVmax-LN, MTV-LN and TLG-LN for EFS and OS showed no significant results ( p> 0.05). Conclusions: We suggested thatSUVmax, MTV and TLG (with a fixed SUV of 2.5) of primary tumor before treatment may be the independent prognostic factors for NPC patients, while SUVmax, MTV and TLG of metastatic lymph node are not.