Radiotherapy & Oncology
Volume 89, Issue 1 , Pages 13-18, October 2008

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers☆

  • Daniel E. Soto

      Affiliations

    • Department of Radiation Oncology, University of Michigan, MI, United States
    • Corresponding Author InformationCorresponding author. Daniel E. Soto, Department of Radiation Oncology, University of Michigan, 1500 E. Medical Center Drive, B2 C490, Box 0010, Ann Arbor, MI 48109-0010, United States.
    • ,
  • Marc L. Kessler

      Affiliations

    • Department of Radiation Oncology, University of Michigan, MI, United States
    • ,
  • Morand Piert

      Affiliations

    • Radiology Department, University of Michigan, MI, USA
    • ,
  • Avraham Eisbruch

      Affiliations

    • Department of Radiation Oncology, University of Michigan, MI, United States

Received 14 February 2008; received in revised form 7 May 2008; accepted 17 May 2008. published online 16 June 2008.

Abstract 

Background and purpose

To assess whether the pretreatment FDG-PET-defined biologic target volume (PET-BTV) correlates with the anatomical sites of loco-regional failure (LRF) after RT for head and neck cancer (HNC).

Materials and methods

We retrospectively identified 61 HNC patients treated definitively with either 3-D CRT or IMRT who had a pre-therapy PET/CT. The GTV and high-risk CTV1 definitions included composite data obtained from diagnostic CT, PET/CT, physical examination, and MRI when available. The median CTV1 dose was 70Gy. 95% received chemotherapy. For patients with LRF, a recurrence volume (Vr) was identified and was mapped to the pretreatment planning CT and pretreatment PET scan.

Results

At a median follow-up of 22 months, 15% (9/61) patients had LRF. For patients with a LRF, 100% (9/9) of failures were inside the GTV. One of nine [11% (95% CI: 3–45%)] had Vr which mapped outside of the pretreatment PET-BTV, while 8/9 patients had Vr within the PET-BTV. Predictors of LRF in our series included GTV volume (p=0.003), but not mean SUV (p=0.13) or max SUV (p=0.25).

Conclusions

Following treatment in which the GTV was defined based on the composite of imaging and physical examination, the majority, but not all, LRF occurred within the PET-BTV. These results support an important, but not exclusive, role of FDG-PET in defining the GTV.

Keywords: Positron-emission tomography, Radiotherapy, Head and neck neoplasms

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☆ Acknowledgment of grant or other financial support: none.

PII: S0167-8140(08)00269-7

doi:10.1016/j.radonc.2008.05.021

Radiotherapy & Oncology
Volume 89, Issue 1 , Pages 13-18, October 2008

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