Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake
Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake
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DOI：
10.1016/j.radonc.2014.06.001
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发表时间：
2014-06-01
影响因子：
5.7
通讯作者：
Specht, Lena
中科院分区：
文献类型：
--
作者：
Due, Anne K.;Vogelius, Ivan R.;Specht, Lena
背景和目的：分析头颈部鳞状细胞癌（HNSCC）患者接受确定性放化疗后的复发模式与靶体积和F-18-氟脱氧葡萄糖（FDG）摄取的正电子发射断层扫描（PET）的关系。材料和方法：520例HNSCC患者从2005年至2009年接受放疗。在100例达到完全临床缓解和后期复发的患者中，39例48个局部区域失败的患者在任何挽救治疗前进行了复发CT扫描。通过可变形图像配准将每次复发的估计原点转移到计划CT。然后将复发位置与描绘的靶体积和相对于最大标准摄取值（SUV）的等SUV轮廓相关。我们将复发密度定义为一个子体积中的复发总数除以所有patients.Results的体积之和：54%（95%CI 37-69%）的复发起源于FDG阳性体积内和96%（95%CI 86-99%）的高剂量区域。复发密度在中心靶区明显增高（P < 0.0001），且随FDG亲和力的增加而增高（P = 0.036）。结论：FDG PET阳性区域或实体瘤复发率最高。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Background and purpose: To analyze the recurrence pattern in relation to target volumes and F-18-fluoro-deoxyglucose (FDG) uptake on positron emission tomography in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive chemoradiation.Material and methods: 520 patients received radiotherapy for HNSCC from 2005 to 2009. Among 100 patients achieving complete clinical response and a later recurrence, 39 patients with 48 loco-regional failures had a recurrence CT scan before any salvage therapy. The estimated point of origin of each recurrence was transferred to the planning CT by deformable image co-registration. The recurrence position was then related to the delineated target volumes and iso-SUV-contours relative to the maximum standard uptake value (SUV). We defined the recurrence density as the total number of recurrences in a sub-volume divided by the sum of that volume for all patients.Results: 54% (95% CI 37-69%) of recurrences originated inside the FDG-positive volume and 96% (95% Cl 86-99%) in the high dose region. Recurrence density was significantly higher in the central target volumes (P < 0.0001) and increased with increasing FDG avidity (P = 0.036).Conclusions: The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor. (C) 2014 Elsevier Ireland Ltd. All rights reserved.