Kyoungjune Pak1, Gi Jeong Cheon2, Hyun-Yeol Nam3, Seong-Jang Kim4, Keon Wook Kang5, June-Key Chung5, E Edmund Kim6, Dong Soo Lee7. 1. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea Medical Research Institute, Pusan National University Hospital, Busan, Korea. 2. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea Cancer Research Institute, Seoul National University Hospital, Seoul, Korea larrycheon@gmail.com. 3. Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. 4. Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea Medical Research Institute, Pusan National University Hospital, Busan, Korea. 5. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea Cancer Research Institute, Seoul National University Hospital, Seoul, Korea. 6. WCU Graduate School of Concergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea; and University of California at Irvine, Irvine, California. 7. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea Cancer Research Institute, Seoul National University Hospital, Seoul, Korea WCU Graduate School of Concergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea; and.
Abstract
UNLABELLED: We conducted a comprehensive systematic review of the literature on volumetric parameters and a meta-analysis of the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with head and neck cancer (HNC). METHODS: A systematic search of MEDLINE and EMBASE was performed using the key words PET, head and neck, and volume. Inclusion criteria were (18)F-FDG PET used as an initial imaging tool; studies limited to HNC; patients who had not undergone surgery, chemotherapy, or radiotherapy before PET scans; and studies reporting survival data. Event-free survival and overall survival were considered markers of outcome. The impact of MTV or TLG on survival was measured by the effect size hazard ratio (HR). Data from each study were analyzed using Review Manager. RESULTS: Thirteen studies comprising 1,180 patients were included in this study. The combined HR for adverse events was 3.06 (2.33-4.01, P < 0.00001) with MTV and 3.10 (2.27-4.24, P < 0.00001) with TLG, meaning that tumors with high volumetric parameters were associated with progression or recurrence. Regarding overall survival, the pooled HR was 3.51 (2.62-4.72, P < 0.00001) with MTV and 3.14 (2.24-4.40, P < 0.00001) with TLG. There was no evidence of significant statistical heterogeneity at an I(2) of 0%. CONCLUSION: MTV and TLG are prognostic predictors of outcome in patients with HNC. Despite clinically heterogeneous HNC and the various methods adopted between studies, we can confirm that patients with a high MTV or TLG have a higher risk of adverse events or death.
UNLABELLED: We conducted a comprehensive systematic review of the literature on volumetric parameters and a meta-analysis of the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with head and neck cancer (HNC). METHODS: A systematic search of MEDLINE and EMBASE was performed using the key words PET, head and neck, and volume. Inclusion criteria were (18)F-FDG PET used as an initial imaging tool; studies limited to HNC; patients who had not undergone surgery, chemotherapy, or radiotherapy before PET scans; and studies reporting survival data. Event-free survival and overall survival were considered markers of outcome. The impact of MTV or TLG on survival was measured by the effect size hazard ratio (HR). Data from each study were analyzed using Review Manager. RESULTS: Thirteen studies comprising 1,180 patients were included in this study. The combined HR for adverse events was 3.06 (2.33-4.01, P < 0.00001) with MTV and 3.10 (2.27-4.24, P < 0.00001) with TLG, meaning that tumors with high volumetric parameters were associated with progression or recurrence. Regarding overall survival, the pooled HR was 3.51 (2.62-4.72, P < 0.00001) with MTV and 3.14 (2.24-4.40, P < 0.00001) with TLG. There was no evidence of significant statistical heterogeneity at an I(2) of 0%. CONCLUSION:MTV and TLG are prognostic predictors of outcome in patients with HNC. Despite clinically heterogeneous HNC and the various methods adopted between studies, we can confirm that patients with a high MTV or TLG have a higher risk of adverse events or death.
Authors: Kimiteru Ito; Heiko Schöder; Rebecca Teng; John L Humm; Ai Ni; Jedd D Wolchok; Wolfgang A Weber Journal: Eur J Nucl Med Mol Imaging Date: 2018-11-28 Impact factor: 9.236