Article Figures & Data
Figures
- FIGURE 1.
Flowchart of study selection.
- FIGURE 2.
Forest plots of HR for events with MTV.
- FIGURE 3.
Forest plots of HR for events with TLG.
- FIGURE 4.
Forest plots of HR for deaths with MTV.
- FIGURE 5.
Forest plots of HR for death with TLG.
- FIGURE 6.
General protocol for analyzing volumetric parameters.
Tables
Cutoff values Study Year Country Study design Quality score (%) No. of patients Disease TNM staging Treatment Endpoints Volumetric parameters VOI Tumor delineation (thresholds) Determination of cutoff values MTV (cm3) TLG Chung et al. (16) 2009 Korea R 80 82 N/O/H I–IV RTx/CCRTx DFS MTV T + LN SUV2.5 Minimum P value method 40 Xie et al. (8) 2009 China R 72.5 41 N I–IV RTx/CCRTx DFS/OS MTV/TLG T SUV2.5 ROC 30 130 Kim et al. (15) 2011 Korea R 72.5 69 Or/O/H/L III/IV op + RTx/op + CCRTx DFS/OS MTV T + LN SUV2.5 Minimum P value method 41 Chan et al. (19) 2011 Taiwan P 85 196 N III/IV CCRTx DFS/OS MTV/TLG T SUV2.5 Minimum P value method 45 330 Park et al. (2) 2013 Korea R 82.5 81 H/L III/IV op/op + RTx/op + CTx LRC/OS MTV T SUV2.5 ROC 18 Kao et al. (17) 2012 Taiwan R 80 64 O/H II–IV CCRTx DFS MTV T SUV2.5 Median 13.6 Chang et al. (18) 2012 Taiwan P 80 108 N I–IV RTx/CCRTx DFS/OS TLG T SUV2.5 Median 65 Dibble et al. (20) 2012 United States R 75 45 Or/O I–IV op/CCRTx/RTx/CTx OS MTV/TLG T Gradient segmentation Median 7.7 55 Lim et al. (21) 2012 United States R 82.5 176 O I–IV CCRTx OS MTV/TLG T SUVmax42% Median 9.6 79.8 Lee et al. (22) 2012 Korea R 85 57 Or I–IV op/op + CTx OS MTV/TLG T SUV2.5 Minimum P value method 7.78 Abd El-Hafez et al. (23) 2013 Taiwan P 85 126 Or II–IV op/op + RTx/op + CCRTx DFS MTV/TLG T SUV3.0 Median 11.2 71.4 Ryu et al. (24) 2013 Korea R 82.5 49 S I–IV op/op + RTx/op + CCRTx PFS/OS MTV/TLG T + LN SUVmax30% ROC 17.7 56.3 Garsa et al. (25) 2013 United States R 70 86 O I–IV RTx DFS/OS MTV/TLG T + LN SUVmax50% ROC 20.5 R = retrospective; N = nasopharynx; O = oropharynx; H = hypopharynx; RTx = radiotherapy; CCRTx = concurrent chemoradiotherapy; DFS = disease-free survival; T = tumor; Or = oral cavity; L = larynx; op = surgery; P = prospective; LRC = locoregional control; CTx = chemotherapy; S = salivary gland; PFS = progression free survival.
Endpoint Volumetric parameters Factor No. of studies HR 95% CI of HR Heterogeneity, I2 (%) Model used EFS MTV VOI: • Tumor 5 3.03 2.22–4.13 0 Random effects • Tumor + LN 3 3.15 1.80–5.51 0 Fixed effect Tumor delineation: • Fixed SUV2.5 6 3.17 2.30–4.36 0 Random effects • Others 2 2.78 1.66–4.66 50 Fixed effect Cutoff values: • ROC 3 4.30 2.46–7.54 0 Fixed effect • Others 5 2.75 2.02–3.75 0 Random effects TLG Tumor delineation: • Fixed SUV2.5 3 3.45 2.33–5.12 0 Fixed effect • Others 2 2.59 1.55–4.31 12 Fixed effect OS MTV VOI: • Tumor 6 3.19 2.28–4.48 0 Random effects • Tumor + LN 2 4.71 2.60–8.54 0 Fixed effect Tumor delineation: • Fixed SUV2.5 4 4.09 2.63–6.36 0 Random effects • Others 4 3.23 1.95–5.34 32 Random effects Cutoff values: • ROC 4 4.57 2.89–7.25 0 Random effects • Others 4 2.93 2.0–4.29 0 Random effects TLG Tumor delineation: • Fixed SUV2.5 3 3.90 2.45–6.21 0 Fixed effect • Others 3 2.46 1.51–4.02 0 Fixed effect Endpoint Parameter HR 95% CI of HR P EFS SUVmax 1.83 1.39–2.42 <0.0001 MTV 3.06 2.33–4.01 <0.00001 TLG 3.10 2.27–4.24 <0.00001 OS SUVmax 2.36 1.48–3.77 0.0003 MTV 3.51 2.62–4.72 <0.00001 TLG 3.14 2.24–4.40 <0.00001 Study Year Country No. of studies No. of patients Classification Effect size Yongkui et al. (29) 2013 China 14 742 Pretreatment, staging, detection of regional nodal metastasis Sensitivity/specificity Xu et al. (31) 2012 China 8 1,147 Pretreatment, staging, detection of distant malignancies Sensitivity/specificity Xu et al. (32) 2011 China 12 1,276 Pretreatment, staging, detection of distant metastases and second primary cancers Sensitivity/specificity Kyzas et al. (30) 2008 Greece 32 1,236 Pretreatment, staging, detection of cervical node metastases Sensitivity/specificity Yi et al. (33) 2013 China 17 2,912 Pretreatment, staging, detection of bone metastasis Sensitivity/specificity Xu et al. (34) 2011 China 15 1,445 Pretreatment, staging, detection of distant metastasis Sensitivity/specificity Isles et al. (36) 2008 United Kingdom 27 917 Posttreatment, follow-up, detection of residual or recurrent disease after chemoradiotherapy Sensitivity/specificity Gupta et al. (35) 2011 India 51 2,335 Posttreatment, follow-up, detection of residual or recurrent disease or metastasis Sensitivity/specificity Zhang et al. (37) 2010 China 8 495 Prognosis, DFS/OS Risk ratio Xie et al. (38) 2011 China 26 1,415 Prognosis, DFS/OS/LRC Odds ratio DFS = disease-free survival; LRC = locoregional control.
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