Measurement of tumor volume by PET to evaluate prognosis in patients with head and neck cancer treated by chemo-radiation therapy

Figures & data

Table I. Patient and disease characteristics at baseline.

	Patients
Characteristics	No	%
Total patients	59
Sex
Male	56	94.9
Female	3	5.1
Age (years)
Median	65
Range	47–81
Primary tumor site
Larynx	38	64.4
Hypopharynx	8	13.6
Oropharynx	13	22
Stage at time of diagnosis
III	26	44.1
IVa	21	35.6
IVb	12	20.3
Neoadjuvant chemotherapy type
Docetaxel/Cisplatin	43	72.9
TS-1/Cisplatin	13	22.0
5-FU/Cisplatin	3	5.0

Table II. Primary tumor and lymph node staging.

Lymph	Primary tumor status
Node status	T1	T2	T3	T4
N0	–	–	10	9
N1	4	8	3	7
N2	2	3	5	6
N3	–	1	1	–

Figure 1. Head and neck tumor volume from an F-18 fluorodeoxyglucose-positron emission tomography (PET) study versus the maximal standardized uptake value (SUVmax) in the primary tumor (correlation coefficient [R2] =0.087). Y= 14.512+1.003*R2, R2=0.087.

Table III. Cox Proportional-hazards modeling parameters for progression free survival from head and neck cancer in all patients

	Coefficient	SE	Coefficient/SE	P	Exp(B)
Stage	0.492	0.375	1.719	0.190	1.635
Lymph node metastasis	0.242	0.228	1.331	0.028	1.274
SUVmax	0.018	0.011	2.658	0.103	1.018
PET MTV	0.010	0.004	4.783	0.029	1.010

MTV, metabolic tumor volume; SE, standard error; Exp (Coefficient), hazard ratio; PET, positron emission tomography; SUVmax, maximal standardized uptake value.

Table IV. Cox proportional-hazards modeling parameters for survival from head and neck cancer in all patients

	Coefficient	SE	Coefficient/SE	P	Exp(B)
Stage	-0.251	0.531	0.223	0.637	0.877
Lymph node metastasis	0.221	0.584	1.143	0.046	1.247
SUVmax	0.014	0.025	0.328	0.567	1.014
PET MTV	0.011	0.007	2.600	0.052	1.011

MTV, metabolic tumor volume; SE, standard error; Exp (Coefficient), hazard ratio; PET, positron emission tomography; SUVmax, maximal standardized uptake value.

Figure 2. Progression free survival for two tumor volume subgroupings: tumor volume ≤ 9.3 cm³, tumor volume > 9.3 cm³, as labeled (p = 0.006).

Figure 3. Overall survival for two tumor volume subgroupings: tumor volume ≤ 9.3 cm³, tumor volume > 9.3 cm³, as labeled (p = 0.051).

Figure 4. Progression free survival for two risk subgroupings: small volumes (≤ 9.3 cm³) and no lymph node involvement [Group I], larger volume and lymph node involvement [Group II], as labeled (p = 0.019).

Figure 5. Overall survival for two risk subgroupings: small volumes (≤ 9.3 cm³) and no lymph node involvement [Group I], larger volume and lymph node involvement [Group II], as labeled (p = 0.037).