Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark.
Radiother Oncol. 2014 Jun;111(3):360-5. doi: 10.1016/j.radonc.2014.06.001. Epub 2014 Jun 30.
To analyze the recurrence pattern in relation to target volumes and (18)F-fluorodeoxyglucose (FDG) uptake on positron emission tomography in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive chemoradiation.
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.
54% (95% CI 37-69%) of recurrences originated inside the FDG-positive volume and 96% (95% CI 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).
The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor.
分析头颈部鳞状细胞癌(HNSCC)患者接受根治性放化疗后,与靶体积和(18)F-氟脱氧葡萄糖(FDG)摄取相关的复发模式。
2005 年至 2009 年间,520 例 HNSCC 患者接受了放疗。在 100 例完全临床缓解但后来复发的患者中,39 例 48 例局部区域复发的患者在任何挽救性治疗前均进行了复发 CT 扫描。通过变形图像配准将每个复发的估计起源点转移到计划 CT 上。然后将复发位置与勾画的靶体积和相对于最大标准摄取值(SUV)的等 SUV 轮廓相关联。我们将复发密度定义为亚体积中复发的总数除以所有患者该体积的总和。
54%(95%CI 37-69%)的复发起源于 FDG 阳性体积内,96%(95%CI 86-99%)起源于高剂量区。中央靶体积的复发密度明显更高(P<0.0001),并且随 FDG 摄取的增加而增加(P=0.036)。
详细的失败模式数据分析表明,大多数复发发生在 FDG PET 阳性区域或实体瘤中。