Evaluation of 18F‐FDG PET/CT as an early imaging biomarker for response monitoring after radiochemotherapy using cetuximab in head and heck squamous cell carcinoma. Issue 2 (9th November 2019)

• Record Type: Journal Article
• Authors: de Galiza Barbosa, Felipe; Riesterer, Oliver; Tanadini‐Lang, Stephanie; Stieb, Sonja; Studer, Gabriela; Pruschy, Martin; Huber, Gerhard F.; Huellner, Martin W.; Stolzmann, Paul; Veit‐Haibach, Patrick
• Is Part Of: Head & neck. Volume 42:Issue 2(2020)
• Page Start: 163
• Page End: 170
• Publication Date: 2019-11-09
• Subjects: 18F‐FDG PET/CT -- cetuximab -- head and neck squamous cell carcinoma -- imaging biomarker -- radiochemotherapy -- response monitoring; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.25975
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: To determine whether 18 F‐PET/CT is able to identify treatment response as early as 1 week after the end of chemoradiotherapy, whether 18 F‐PET/CT can identify prognostic markers concerning progression free survival and can identify patients who need additional consolidation therapy. Methods: A total of 54 patients with head and neck cancer were prospectively enrolled in this single‐center, randomized study from 03/2012‐04/2015. Patients underwent FDG‐PET/CT imaging at three predefined time points: pretreatment (PET/CT1), 1 week postprimary radiochemotherapy (PET/CT2) and 3 months postprimary radiochemotherapy (PET/CT3). Tumors were assessed quantitatively based on size and glucose uptake (SUVmax) concerning response at each time point. Response assessment was correlated with progression free survival. All patients had a minimum follow‐up period of 18 months. Multivariate regression analysis was performed to find independent predictors for progression free survival (PFS). Results: Thirty‐two (32) patients (64%) overall remained disease free, 11 patients (22%) had recurrence and 7 patients (14%) had persistent disease. There was no significantly different metabolic parameter ratio found concerning responders and nonresponders at posttreatment (PET/CT2 and 3) time points ( P > .05) during clinical follow‐up. Multivariate regression analysis demonstrated both SUVmax and diameter assessed at time point PET/CT3 represent independent predictors of progression free survival (PFS). There was also no statistically significant difference in PFS between responders and nonresponders by means of PET/CT2 in both study arms ( P > .05). Imaging responders at time point PET/CT3 showed a significantly longer PFS compared to nonresponders after the end of consolidation therapy ( P < .01). Conclusions: Early response of head/neck cancer after radiochemotherapy can be accurately assessed with PET/CT 1 week after RCT. SUVmax and lesion diameter are independent predictors of PFS at time point PET/CT3. PET/CT2 has no prognostic value concerning PFS and cannot identify high risk patients for consolidation therapy. Imaging responders showed a significantly longer PFS compared to nonresponders and therefore PET/CT might serve as a prognostic biomarker. Trial registration: Clinical Trials.gov identifier: NCT01435252.