ISSN: 2149-2247 | E-ISSN: 2149-2549
Pretreatment Metabolic Tumor Volume of Primary Tumor and Total Lesion Glycolysis of Lymph Nodes are Predictive in Nasopharyngeal Cancer [Erciyes Med J]
Erciyes Med J. 2020; 42(4): 386-394 | DOI: 10.14744/etd.2020.14564

Pretreatment Metabolic Tumor Volume of Primary Tumor and Total Lesion Glycolysis of Lymph Nodes are Predictive in Nasopharyngeal Cancer

Mete Gündoğ1, Ummuhan Abdulrezzak2
1Department of Radiation Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey
2Department of Nuclear Medicine, Erciyes University Faculty of Medicine, Kayseri, Turkey

Objective: Conventional prognostic factors are not yet sufficient to predict treatment outcomes factors in nasopharyngeal carcinoma (NPC). Parameters from PET/CT are still being investigated as a prognostic factor in nasopharyngeal cancer.
Materials and Methods: We retrospectively analyzed total lesion glycolysis (TLG), metabolic tumor volume (MTV), and maximum standardized uptake value (SUVmax) in patients with non-metastatic nasopharyngeal cancer treated with intensity-adjusted radiotherapy. According to the ROC analysis, we divided the whole cohort into two groups. Kaplan-Meier tests were used to evaluate survival differences between groups. Univariate and multivariate analyzes were performed to find the factors affecting the prognosis. P<0.05 was accepted as statistically significant.
Results: Ninety-one non-metastatic nasopharyngeal cancer patients were enrolled in this study. According to cut-off values, both MTVtumor and TLGnode were found as an independent prognostic factor for overall survival (OS). High MTVtumor (>21.5) and high TLGnode (>186.7) correlated with 4.9 and 4-fold increased mortality risk, respectively. Multivariate analyses showed high MTVtotal (>59.5) was associated with a 3.3 fold increased risk of locoregional recurrence. High TLGtotal (>181.56) was found to be independent prognostic factor for distant metastasis-free survival and it was associated with a 5.4 fold increased risk. The 5-years OS rate was 58.5% in high MTVtotal (>59.5) patients and 82.4% in low MTVtotal (<59.5) patients (p<0.01). The 5-years OS rates were 64.2% in patients with high TLGtotal (>181) and 88% in patients with low TLGtotal (p<0.01).
Conclusion: The results of our study showed that MTVtumor and TLGnode values are significant independent prognostic factors for OS.

Keywords: Metabolic tumor volume, total lesion glycolysis, PET-derived parameters, nasopharyngeal cancer

Mete Gündoğ, Ummuhan Abdulrezzak. Pretreatment Metabolic Tumor Volume of Primary Tumor and Total Lesion Glycolysis of Lymph Nodes are Predictive in Nasopharyngeal Cancer. Erciyes Med J. 2020; 42(4): 386-394

Corresponding Author: Mete Gündoğ, Türkiye
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