Prediction of Survival and Therapy Outcome with 11C-Tyrosine PET in Patients with Laryngeal Carcinoma

Journal of Nuclear Medicine

Jan Pruim¹  Willem Vaalburg¹  Jurjan R. de Boer¹  Bernard F.A.M. van der Laan¹  Frans W.J. Albers¹  Fred Burlage¹ 

关键词: l-[1-¹¹C]-tyrosine;    PET;    head and neck tumors;    prediction;    survival;    therapy outcome;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Choosing the optimal treatment for an individual with squamous cell carcinoma of the head and neck is a difficult challenge because of the unpredictable clinical behavior of this malignancy. A reliable method for assessing the clinical behavior and predicting the radiocurability of tumors would assist in the therapy strategy and prognosis. This study evaluated whether quantitative PET using l-[1-11C]-tyrosine (TYR) has predictive value for survival and therapy outcome in patients with primary squamous cell carcinoma of the larynx. Methods: Thirty-four patients with histologically confirmed laryngeal carcinomas underwent dynamic 11C-TYR PET before receiving definitive therapy. Various methods for quantification of tumor activity were used: assessment of protein synthesis rate (PSR), calculation of standardized uptake value, and estimation of tumor-to-nontumor ratio. Treatment consisted of radiotherapy (n = 20) or surgery (n = 14). The median follow-up was 40 mo. Results: All malignancies were identified correctly, with no false-negative results. Cumulative survival was compared between patients with tumor PSR equal to or higher than the median (2.0 nmol/mL/min) and those with tumor PSR lower than the median and was found not to be significantly different (P = 0.07). When the radiotherapy group was evaluated separately, the difference in survival was significant (P = 0.03; 5-y survival, 30% vs. 73%) and high 11C-TYR uptake correlated with poor prognosis. In multivariate analysis, PSR was an independent predictor for survival. Because differences (P = 0.08) between patients with and patients without recurrence were not significant, no predictive value of PSR for disease recurrence could be demonstrated. Conclusion: Prediction of survival of patients undergoing radiotherapy for laryngeal squamous cell carcinoma is feasible primarily by using 11C-TYR PET to quantify activity before treatment.

【 授权许可】

Unknown