MHNC: Pre-treatment SUV predicts treatment outcomes in head and neck cancer

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Pre-treatment maximal standardized uptake value (SUVmax) from FDG PET imaging of the primary tumor in head and neck squamous cell carcinoma patients is a strong predictor of  prognosis, while pre-treatment SUVmax of the lymphadenopathy is significantly associated with distant metastasis, according to a study presented on Feb. 26 at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Ariz.

The study included 295 patients treated with intensity-modulated radiation therapy (IMRT) and 177 (137 males and 40 females) who had FDG PET before treatment and had a record of SUVmax for either primary tumor (SUVp) and/or lymphadenopathy (SUVln) were included in the analysis.
The three-year distant metastasis-free survival and disease specific survival rates was 78.8 percent for all patients, the disease-free survival rate was 63.95 percent and overall survival rate was 67.4 percent, said Min Yao, MD, PhD, lead author of the study and associate professor at University Hospitals Case Medical Center in Cleveland, Ohio.

SUVln may be used to select patients for regimens including induction chemotherapy. The researchers found that distant metastasis-free survival rate was 82.1 percent at three years when the SUVln was less than 11.3 and 63.4 percent when the SUVln was greater than 11.3.

"The findings of this study show that we may use SUV before treatment to personalize treatment approaches for some head and neck cancer patients since SUV has been shown to be associated with treatment outcomes," said Yao.

"Higher SUV may mean more aggressive treatment approaches, and since we now know that SUV of the lymph node is associated with distant metastasis, those patients with high SUVln may need more aggressive systemic chemotherapy," Yao added.