J Cancer 2020; 11(23):7073-7080. doi:10.7150/jca.46490 This issue

Research Paper

Volumetric parameters derived from FLT-PET performed at completion of treatment predict efficacy of Carbon-ion Radiotherapy in patients with locally recurrent Nasopharyngeal Carcinoma

Jiyi Hu1,3, Zhongyi Yang4,5,6,7, Jing Gao1,3, Weixu Hu1,3, Jing Yang1,3, Xianxin Qiu1,3, Yingjian Zhang4,5,6,7, Guang Ma4, Lin Kong2,3, Jiade J. Lu1,3✉

1. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai 201321, China.
2. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China.
3. Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy.
4. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, China.
5. Department of Oncology, Shanghai Medical College, Fudan University, China.
6. Center for Biomedical Imaging, Fudan University, China.
7. Shanghai Engineering Research Center of Molecular Imaging Probes, China.

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Citation:
Hu J, Yang Z, Gao J, Hu W, Yang J, Qiu X, Zhang Y, Ma G, Kong L, Lu JJ. Volumetric parameters derived from FLT-PET performed at completion of treatment predict efficacy of Carbon-ion Radiotherapy in patients with locally recurrent Nasopharyngeal Carcinoma. J Cancer 2020; 11(23):7073-7080. doi:10.7150/jca.46490. Available from https://www.jcancer.org/v11p7073.htm

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Abstract

The purpose of this study was to investigate the role of 3'-deoxy-3'-[18F]fluorothymidine (FLT)-PET for predicting the outcome of patients with locally recurrent nasopharyngeal carcinoma (LR-NPC) treated by carbon-ion radiotherapy (CIRT). Patients received FLT-PET/CT scan one-week prior to or after completion of CIRT were enrolled in the study. All patients were from prospective trials or treated using a standardized protocol. Time-dependent receiver operator characteristics (ROC) were used to determine the optimal cutoff values for FLT-PET parameters. Univariable and multivariable analyses of local progression-free survival (LPFS) were performed using Cox regression, to examine the prognostic value of FLT-PET parameters, including SUVmax, metabolic tumor volume (MTV) and total lesion thymidine (TLT). A total of 41 patients were enrolled. Elevated MTV and TLT were significantly associated with worse LPFS, in both univariable and multivariable analyses. ROC analysis revealed that both an MTV value higher than 8.6 and a TLT value higher than 14.9 were predictive of increased risk of developing local recurrence, the adjusted HRs were 5.59 (p=0.009) and 7.76 (p=0.002), respectively. In conclusion, FLT-PET was found to be a promising prognostic tool for LR-NPC patients and might play a role in the treatment guidance.

Keywords: locally recurrent nasopharyngeal carcinoma, 3'-deoxy-3'-[18F]fluorothymidine, outcome prediction