Abstract
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Background: The role of induction chemotherapy in locally advanced oropharyngeal cancer is still debatable. This study aims to assess the role of FDG PET/CT performed pre-and post-induction chemotherapy in prognosis of locally advanced oropharyngeal carcinoma patients.
Methods: Twenty five locally advanced oropharyngeal carcinoma patients who underwent FDG PET/CT before and after 1~3 cycles of platinum-based induction chemotherapy were included. Tumor response was assessed with follow-up PET/CT using the Hopkins criteria. Also, metabolic parameters for primary tumor and lymph nodes were measured at baseline PET/CT. Treatment response and baseline PET/CT parameters were analyzed for overall survival (OS) and progression-free survival (PFS). Sub-group analysis was done according to HPV status, if status was known.
Results: Median follow-up was 43.5 months. On whole group analysis, non-responders (n = 13) on follow-up PET/CT had a tendency for earlier progression compared the responders (n = 12). On multivariate analysis, primary tumor MTV was an independent predictor for OS (Odds ratio 4.8, p = 0.020). 18 patients had information on HPV status. In patients with positive HPV (n = 13) there was a tendency for less progression and death in responders (n = 6, 0 progression, 1 death) than in non-responders (n=7, 3 progression, 3 deaths).
Conclusions: In locally advanced oropharyngeal carcinoma patients, response evaluation of induction chemotherapy with FDG PET/CT using Hopkins criteria may provide information for survival prognosis, especially in HPV positive cases. Primary tumor MTV on baseline PET/CT can be also be a biomarker for prognosis.
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