Benefit of [18F] FDG PET/CT in the diagnosis and salvage treatment of recurrent nasopharyngeal carcinoma

OuYang, Pu‐Yun; Liu, Zhi-Qiao; Q, Lin; He, Ying; Guo, Zhixin; Yao, Wenyan; Xu, Sen-Kui; Peng, Qifeng; Xiao, Su-Ming; Li, Jiajian; Li, Anwei; Zhang, Bao-Yu; Yang, Shanshan; Wang, Fan; Xie, Congying; Wu, Yaopan; Zhang, Xu; Chen, Chunyan; Xie, Fang‐Yun

doi:10.1007/s00259-022-06020-3

Cited by 8 publications

(11 citation statements)

References 27 publications

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“…Tongue pain and dyskinesia re ect the clinical signs of PNI. We took the method given by Dae Young Yoon et al to minimize the subjectivity of surgeons to discriminate RLNM [51,52]. Our study also showed that RLNM (OR: 4.378, 95%CI: 1.916-10.476) correlated with CLNM.…”

Section: Discussionsupporting

confidence: 57%

The application of nomogram model integrating clinical factors and multi-modal MRI radiomics features for predicting cervical lymph nodes metastasis for patients with oral tongue squamous cell carcinoma: a multicenter study

Liu,

Xiong,

Zhang

et al. 2024

Preprint

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Background The aim of this study was to build and test the nomogram model integrating clinical factors and multi-modal MRI radiomics features to predict the risk of cervical lymph nodes metastasis (CLNM) in oral tongue squamous cell carcinoma (OTSCC) patients, and further validate the clinical utility of the model in cT1-T2 subgroup and cN0 subgroup. Materials and Methods A total of 326 patients enrolled from 2 centers made up group Ⅰ (including T1-Weighted Images (T1WI) and Fat-suppressed T2-Weighted Images (FS-T2WI)) and group Ⅱ (including T1WI, FS-T2WI and T1-Weighted Contrast Enhanced MRI (CE-MRI)). Patients were divided into training set, internal test set and external test set. Radiomics features from the three MRI sequences and clinical factors were extracted and selected. Radiomics models, clinical models and the combined models (nomogram models) integrating clinical factors and multi-modal MRI radiomics features were constructed respectively in two groups. cN0 subgroup and cT1-T2 subgroup analyses were performed. The performance of the three models was compared. Results The combined model integrating clinical factors and multi-modal MRI radiomics features in group Ⅱ had the best performance, with the AUCs of 0.983, 0.944 and 0.770 in the training set, internal test set and external test set. cN0 subgroup and cT1-T2 subgroup analyses confirmed excellent performance of the combined model in group Ⅱ, with the AUCs of 0.975 (0.944–0.992), 0.944 (0.720-1.000) and 0.728 (0.553–0.843) for cN0 subgroup, and the AUCs of 0.959 (0.860-1.000), 0.960 (0.871-1.000) and 0.804 (0.506-1.000) for cT1-T2 subgroup. Conclusions The combined model based on clinical factors and multi-modal MRI radiomics features including T1WI, FS-T2WI and CE-MRI can well predict the risk of preoperative CLNM for OTSCC patients.

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Section: Discussionsupporting

confidence: 57%

The application of nomogram model integrating clinical factors and multi-modal MRI radiomics features for predicting cervical lymph nodes metastasis for patients with oral tongue squamous cell carcinoma: a multicenter study

Liu,

Xiong,

Zhang

et al. 2024

Preprint

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“…It is undeniable that [18 F]-FDG PET/CT is unable to detect skull base involvement and intracranial extension, as well as brown fat throughout the head and neck region, which may be one of the reasons why radiotherapists prefer MRI for staging and target area delineation in the initial diagnosis of nasopharyngeal carcinoma in clinical practice [ 12 – 14 ]. However, several studies have demonstrated that PET/CT has higher sensitivity and specificity compared to MRI in the diagnosis of local and lymph node recurrence in NPC at recurrence [ 15 – 17 ]. A meta-analysis by Li et al showed that patients MRI versus (vs.).…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of pre-treatment [18F] FDG PET/CT in recurrent nasopharyngeal carcinoma without distant metastasis

Dong,

Wang,

Dai

et al. 2024

BMC Cancer

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Background [18 F]-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has the ability to detect local and/or regional recurrence as well as distant metastasis. We aimed to evaluate the prognosis value of PET/CT in locoregional recurrent nasopharyngeal (lrNPC). Methods A total of 451 eligible patients diagnosed with recurrent I-IVA (rI-IVA) NPC between April 2009 and December 2015 were retrospectively included in this study. The differences in overall survival (OS) of lrNPC patients with and without PET/CT were compared in the I-II, III-IVA, r0-II, and rIII-IVA cohorts, which were grouped by initial staging and recurrent staging (according to MRI). Results In the III-IVA and rIII-IVA NPC patients, with PET/CT exhibited significantly higher OS rates in the univariate analysis (P = 0.045; P = 0.009; respectively). Multivariate analysis revealed that with PET/CT was an independent predictor of OS in the rIII-IVA cohort (hazard ratio [HR] = 0.476; 95% confidence interval [CI]: 0.267 to 0.847; P = 0.012). In the rIII-IVA NPC, patients receiving PET/CT sacns before salvage surgery had a better prognosis compared with MRI alone (P = 0.036). The recurrent stage (based on PET/CT) was an independent predictor of OS. (r0-II versus [vs]. rIII-IVA; HR = 0.376; 95% CI: 0.150 to 0.938; P = 0.036). Conclusion The present study showed that with PET/CT could improve overall survival for rIII-IVA NPC patients. PET/CT appears to be an effective method for assessing rTNM staging.

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“…Third, advances in imaging have contributed to nasopharyngeal carcinoma staging and radiotherapy. MRI showed advantages for its high-contrast resolution, while 18F-FDG positron emission tomography demonstrated greater sensitivity and specificity in detecting tumor lesions . Thus, the application of different imaging modalities leads to more accurate tumor staging and guides subsequent clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

Induction Chemotherapy Followed by Radiotherapy vs Chemoradiotherapy in Nasopharyngeal Carcinoma

Dai,

Zhang,

et al. 2024

JAMA Oncol

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ImportanceInduction chemotherapy plus concurrent chemoradiotherapy is recommended for locoregionally advanced nasopharyngeal carcinoma but is associated with higher rates of acute toxic effects and low compliance. Evidence on de-escalating treatment intensity after induction chemotherapy is limited.ObjectiveTo assess if radiotherapy was noninferior to chemoradiotherapy after induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma.Design, Setting, and ParticipantsFrom April 2015 to March 2018, a multicenter, open-label, randomized, noninferiority, phase 3 trial was conducted at 5 Chinese hospitals. A total of 383 patients aged 18 to 70 years with an untreated histologically confirmed nonkeratinizing tumor, Karnofsky performance status score not worse than 70, proper organ function, and stage III to IVB nasopharyngeal cancer were enrolled. Data were analyzed from April 2023 to June 2023.InterventionsPatients were assigned randomly. Both groups received 3 cycles of induction chemotherapy consisting of intravenous administration (on day 1) of cisplatin at 60 mg/m2 and docetaxel at 60 mg/m2 and continuous intravenous infusion (from day 1 to day 5) of daily fluorouracil (600 mg/m2), repeated every 21 days. Subsequently, the patients received radiotherapy alone (induction chemotherapy in combination with radiotherapy [IC-RT] group) or concomitant cisplatin (30 mg/m2/week) with radiotherapy for 6 to 7 weeks (induction chemotherapy combined with chemoradiotherapy [IC-CCRT] group).Main Outcomes and MeasuresThe primary end point was 3-year progression-free survival (time from the initiation of therapy until the first indication of disease progression or death), with a noninferiority margin of 10%. The secondary end points included overall survival, locoregional failure-free survival, distant metastasis-free survival, response rate, and toxic effects.ResultsA total of 383 patients (median [range] age, 48 [19-70] years; 100 women [26%]). Median follow-up time was 76 months (IQR, 70-89 months). The 3-year progression-free survival was 76.2% and 76.8% in the IC-RT (n = 193) and IC-CCRT groups (n = 190), respectively, in the intention-to-treat population, showing a difference of 0.6% (95% CI, –7.9% to 9.1%; P = .01 for noninferiority). Identical outcomes were reported in the per-protocol population. The incidence of grade 3 to 4 short-term toxic effects in the IC-RT group was less than the IC-CCRT group. No differences were observed in late toxic effects.Conclusions and RelevanceThe results of this randomized clinical trial suggest that after induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma, radiotherapy alone was noninferior to chemoradiotherapy in terms of 3-year progression-free survival.Trial RegistrationClinicalTrials.gov Identifier: NCT02434614

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Benefit of [18F] FDG PET/CT in the diagnosis and salvage treatment of recurrent nasopharyngeal carcinoma

Cited by 8 publications

References 27 publications

The application of nomogram model integrating clinical factors and multi-modal MRI radiomics features for predicting cervical lymph nodes metastasis for patients with oral tongue squamous cell carcinoma: a multicenter study

The application of nomogram model integrating clinical factors and multi-modal MRI radiomics features for predicting cervical lymph nodes metastasis for patients with oral tongue squamous cell carcinoma: a multicenter study

Prognostic value of pre-treatment [18F] FDG PET/CT in recurrent nasopharyngeal carcinoma without distant metastasis

Induction Chemotherapy Followed by Radiotherapy vs Chemoradiotherapy in Nasopharyngeal Carcinoma

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