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Pre-CCRT 18-fluorodeoxyglucose PET-CT improves survival in patients with advanced stages p16-negative oropharyngeal squamous cell carcinoma via accurate radiation treatment planning.
- Source :
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Journal of Otolaryngology -- Head & Neck Surgery . 2/13/2023, Vol. 52 Issue 1, p1-13. 13p. - Publication Year :
- 2023
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Abstract
- Purpose: No large-scale prospective randomized study with a long-term follow-up period has evaluated the survival outcomes of preconcurrent chemoradiotherapy (CCRT) 18-fluorodeoxyglucose positron emission tomography–computed tomography (18FDG PET–CT) in patients with non–human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). Patients and Methods: We included patients with stage I–IVA p16-negative OPSCC receiving definitive CCRT and categorized them into two groups according to pre-CCRT 18FDG PET–CT and compared their outcomes: the case group consisted of patients who underwent pre-CCRT 18FDG PET–CT, whereas the comparison group consisted of patients who did not receive pre-CCRT 18FDG PET–CT. Results: The final cohort consisted of 3942 patients (1663 and 2279 in the case and comparison groups, respectively). According to multivariable Cox regression analysis, pre-CCRT 18FDG PET–CT was not a significant prognostic factor for overall survival in patients with stages I–II of p16-negative OPSCC receiving standard CCRT. The adjusted hazard ratio (95% confidence interval) of all-cause death for the patients with advanced stages (III–IVA) of p16-negative OPSCC receiving pre-CCRT 18FDG PET–CT was 0.75 (0.87–0.94, P = 0.0236). Conclusions: Routine use of pre-CCRT 18FDG PET–CT is not necessary for each patient with p16-negative OPSCC. Pre-CCRT 18FDG PET–CT is associated with improved survival in patients with stage III–IVA p16-negative OSCC, but might be not in those with stage I–II p16-negative OPSCC. No large-scale prospective randomized study with a long-term follow-up period has evaluated the survival outcomes of preconcurrent chemoradiotherapy (CCRT) 18-fluorodeoxyglucose positron emission tomography–computed tomography (18FDG PET–CT) in patients with p16-negative oropharyngeal squamous cell carcinoma (OPSCC). Our study is the first, largest, homogenous modality study on PET–CT including a long-term follow-up cohort to examine the survival outcomes of pre-CCRT 18FDG PET–CT or non-pre-CCRT PET–CT for patients with p16-negative OPSCC receiving standard CCRT stratified by different clinical stages. Routine use of pre-CCRT 18FDG PET–CT is not necessary for each patient with p16-negative OPSCC. Pre-CCRT 18FDG PET–CT is associated with improved survival in patients with stage III–IVA p16-negative OPSCC, but might be not in those with stage I–II p16-negative OPSCC. [ABSTRACT FROM AUTHOR]
- Subjects :
- *DISEASE progression
*CAUSES of death
*CONFIDENCE intervals
*MULTIPLE regression analysis
*POSITRON emission tomography computed tomography
*OROPHARYNGEAL cancer
*HEAD & neck cancer
*HEALTH outcome assessment
*CHEMORADIOTHERAPY
*TUMOR classification
*CANCER patients
*RANDOMIZED controlled trials
*TREATMENT effectiveness
*COMPARATIVE studies
*RADIOPHARMACEUTICALS
*POSITRON emission tomography
*RADIATION doses
*DESCRIPTIVE statistics
*RESEARCH funding
*DEOXY sugars
*STATISTICAL sampling
*SQUAMOUS cell carcinoma
*HEALTH planning
*LONGITUDINAL method
*OVERALL survival
*PROPORTIONAL hazards models
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 07077270
- Volume :
- 52
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Otolaryngology -- Head & Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 162181192
- Full Text :
- https://doi.org/10.1186/s40463-023-00623-y