Prognostic values of ¹⁸F-FDG PEX/CT parameters in patients with nasopharyngeal carcinoma

Objective: At present, nasopharyngeal carcinoma (NPC) is a head and neck cancer with special geographical distribution and biological behavior. Studies have shown that ¹⁸F-FDG PET/CT parameters have certain prognostic values in patients with NPC in high-incidence areas. The aim of this study is to investigate the prognostic values of ¹⁸F-FDG PET/CT parameters in patients with NPC in low-incidence areas. Methods: The clinical data of 83 NPC patients who were diagnosed and treated in Beth Israel Medical Center, Albert Einstein Medical College from January 2003 to December 2013 were analyzed retrospectively. Based on ¹⁸F-FDG PET/CT images, gross tumor volume (GTV) was delineated using the gradient method to obtain ¹⁸F-FDG PET/CT parameters: maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Results: The number of patients followed was 37 at 3-years time. For all patients, the 3-year failure-free survival, locoregional relapse-free survival, and metastasis-free survival rates were 74%, 88%, and 85%, respectively. The univariate analysis showed that SUV_max of the primary tumor (P = 0.004) and TLG (P = 0.014) were prognostic factors for 3-year locoregional relapse-free survival rate, and SUV_max of the primary tumor (0.024) and TLG (P = 0.033) were prognostic factors for 3-ear failure-free survival rate. The multivariate analysis showed that SUV_max of the primary tumor was the independent prognostic factor for 3-year failure-free survival rate. Conclusion: SUV_max of the primary tumor before treatment is the independent prognostic factor for failure-free survival in patients with NPC. (authors)