Clinical T staging is superior to fluorodeoxyglucose positron emission tomography for predicting local outcomes after intra-arterial infusion chemoradiotherapy for maxillary sinus squamous cell carcinoma
Clinical T staging is superior to fluorodeoxyglucose positron emission tomography for predicting local outcomes after intra-arterial infusion chemoradiotherapy for maxillary sinus squamous cell carcinoma
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DOI：
10.18999/nagjms.80.4.541
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发表时间：
2018-11-01
影响因子：
0.9
通讯作者：
Yamakado, Koichiro
中科院分区：
文献类型：
--
作者：
Doi, Hiroshi;Fujiwara, Masayuki;Yamakado, Koichiro
动脉灌注同步放化疗（IA-CRT）已被用于治疗局部晚期上颌窦鳞状细胞癌（MSSCC），取得了积极的结果。然而，一个最佳的预测预后因素MSSCC治疗IA-CRT仍然难以捉摸。本研究的目的是评估18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）的可行性，包括体积参数，以预测MSSCC与IA-CRT治疗的预后。在这项回顾性研究中，分析了24例新诊断的MSSCC患者在IA-CRT治疗前接受FDG-PET成像。所有患者均接受放疗，肿瘤总剂量为60-66戈伊，采用常规分割方案，采用三维适形放射治疗或调强放射治疗。放疗同时进行，同时动脉灌注化疗（顺铂）。IA-CRT有效率为83.33%。1、3年生存率分别为81.30%和64.34%。1年和3年局部无失败率分别为57.21%和40.96%。局部失败与不良生存率显著相关（P = 0.0152）。此外，临床T分期对临床T3或更低、T4 a和T4 b患者的局部控制结局进行了明显分层（P = 0.0312）。此外，T4 b期患者的局部控制显著差于T3或更低（P = 0.0103）。然而. FDG-PET参数未提供有关治疗结局的显著预测信息。总之，治疗前T分期预测IA-CRT的局部控制，这与生存相关。
Concomitant intra-arterial infusion chemoradiotherapy (IA-CRT) has been used to treat locally advanced maxillary sinus squamous cell carcinoma (MSSCC) with positive outcomes. However, an optimal predictive prognostic factor for MSSCC treated with IA-CRT remains elusive. The aim of the present study was to assess the feasibility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), including volumetric parameters, to predict the prognosis of MSSCC treated with IA-CRT. Twenty-four patients with newly diagnosed MSSCC receiving FDG-PET imaging before IA-CRT treatment were analyzed in this retrospective study. All patients underwent radiotherapy with a total tumor dose of 60-66 Gy in a conventional fractionation schedule, using three-dimensional conformal radiation therapy or intensity-modulated radiation therapy. Radiotherapy was performed concurrently with concurrent intra-arterial infusion chemotherapy (cisplatin). The IA-CRT response rate was 83.33%. The 1- and 3-year survival rates were 81.30% and 64.34%, respectively. The 1- and 3-year local failure-free rates were 57.21% and 40.96%, respectively. Local failure was significantly associated with poor survival (P = 0.0152). Further, clinical T staging dearly stratified local control outcomes among patients with clinical T3 or less, T4a, and T4b (P = 0.0312). Moreover, patients with stage T4b showed a significantly poorer local control compared with T3 or less (P = 0.0103). However. FDG-PET parameters provided no significant predictive information regarding treatment outcome. To conclude, pretreatment T stage predicts local control by IA-CRT, which is associated with survival.