Faculty Collaboration Database

Post-treatment PET/CT and p16 status for predicting treatment outcomes in locally advanced head and neck cancer after definitive radiation. Eur J Nucl Med Mol Imaging 2017 Jun;44(6):988-997

Date

01/17/2017

Pubmed ID

28091733

DOI

10.1007/s00259-016-3612-1

Scopus ID

2-s2.0-85009495122 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

PURPOSE: To retrospectively review post-treatment (post-tx) FDG-PET/CT scans in patients with advanced head and neck squamous cell carcinoma (HNSCC) and known p16 status, treated with definitive (chemo)radiation (RT).

METHODS: A total of 108 eligible patients had N2A or greater HNSCC treated with chemoRT from August 1, 2008, to February 28, 2015, with post-tx PET/CT within 6 months after RT. Kaplan-Meier curves, log-rank statistics, and Cox proportional hazards regression were used for statistical analysis.

RESULTS: Median follow-up was 2.38 years. Sixty-eight (63.0%) patients had p16+ and 40 (37.0%) had p16- status. Two-year overall survival and recurrence-free survival were 93.4% and 77.8%, respectively. The negative predictive value (NPV) of PET/CT for local recurrence (LR) was 100%. The NPV for regional recurrence (RR) was 96.5% for all patients, 100% for p16+ patients, and 88.5% for p16- patients. The positive predictive value (PPV) of PET/CT for recurrence was 77.3% for all patients, 50.0% for p16+, and 78.6% for p16-. The PPV for LR was 72.7% for all patients, 50.0% for p16+ patients, and 72.7% for p16- patients. The PPV for RR was 50.0% for all patients, 33% for p16+, and 66.6% for p16-. Post-tx PET/CT and p16 status were independent predictors of recurrence-free survival (p < 0.01).

CONCLUSIONS: Post-tx PET/CT predicts treatment outcomes in both p16 + and p16- patients, and does so independently of p16 status. P16- patients with negative PET have a 10% risk of nodal recurrence, and closer follow-up in these patients is warranted.

Author List

Awan MJ, Lavertu P, Zender C, Rezaee R, Fowler N, Karapetyan L, Gibson M, Wasman J, Faulhaber P, Machtay M, Yao M

Author

Musaddiq J. Awan MD Assistant Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Carcinoma, Squamous Cell
Cyclin-Dependent Kinase Inhibitor p16
Female
Head and Neck Neoplasms
Humans
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Retrospective Studies
Treatment Outcome