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PET-Based Prognostic Survival Model After Radiotherapy for Head and Neck Cancer

J. Castelli, A. Depeursinge, A. Devillers, B. Campillo-Gimenez, Y. Dicente, J.O. Prior, E. Chajon, F. Jegoux, C. Sire, O. Acosta, E. Gherga, X. Sun, B. De Bari, J. Bourhis, R. de Crevoisier

European Journal of Nuclear Medicine and Molecular Imaging, vol. 46, no. 3, pp. 638-649, March 2019.


Purpose The aims of this multicentre retrospective study of locally advanced head and neck cancer (LAHNC) treated with definitive radiotherapy were to (1) identify positron emission tomography (PET)-18F-fluorodeoxyglucose (18F-FDG) parameters correlated with overall survival (OS) in a training cohort, (2) compute a prognostic model, and (3) externally validate this model in an independent cohort.

Materials and methods A total of 237 consecutive LAHNC patients divided into training (n = 127) and validation cohorts (n = 110) were retrospectively analysed. The following PET parameters were analysed: SUVMax, metabolic tumour volume (MTV), total lesion glycolysis (TLG), and SUVMean for the primary tumour and lymph nodes using a relative SUVMax threshold or an absolute SUV threshold. Cox analyses were performed on OS in the training cohort. The c-index was used to identify the highly prognostic parameters. A prognostic model was subsequently identified, and a nomogram was generated. The model was externally tested in the validation cohort.

Results In univariate analysis, the significant PET parameters for the primary tumour included MTV (relative thresholds from 6 to 83% and absolute thresholds from 1.5 to 6.5) and TLG (relative thresholds from 1 to 82% and absolute thresholds from 0.5 to 4.5). For the lymph nodes, the significant parameters included MTV and TLG regardless of the threshold value. In multivariate analysis, tumour site, p16 status, MTV35% of the primary tumour, and MTV44% of the lymph nodes were independent predictors of OS. Based on these four parameters, a prognostic model was identified with a c-index of 0.72. The corresponding nomogram was generated. This prognostic model was externally validated, achieving a c-index of 0.66.

Conclusions A prognostic model of OS based on primary tumour and lymph node MTV, tumour site, and p16 status was proposed and validated. The corresponding nomogram may be used to tailor individualized treatment.

@ARTICLE(http://bigwww.epfl.ch/publications/castelli1901.html,
AUTHOR="Castelli, J. and Depeursinge, A. and Devillers, A. and
	Campillo-Gimenez, B. and Dicente, Y. and Prior, J.O. and Chajon, E.
	and Jegoux, F. and Sire, C. and Acosta, O. and Gherga, E. and Sun,
	X. and De Bari, B. and Bourhis, J. and de Crevoisier, R.",
TITLE="{PET}-Based Prognostic Survival Model After Radiotherapy for Head
	and Neck Cancer",
JOURNAL="European Journal of Nuclear Medicine and Molecular Imaging",
YEAR="2019",
volume="46",
number="3",
pages="638--649",
month="March",
note="")

© 2019 . Personal use of this material is permitted. However, permission to reprint/republish this material for advertising or promotional purposes or for creating new collective works for resale or redistribution to servers or lists, or to reuse any copyrighted component of this work in other works must be obtained from . This material is presented to ensure timely dissemination of scholarly and technical work. Copyright and all rights therein are retained by authors or by other copyright holders. All persons copying this information are expected to adhere to the terms and constraints invoked by each author's copyright. In most cases, these works may not be reposted without the explicit permission of the copyright holder.
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