RT Journal Article SR Electronic T1 Use of 18F-FDG PET for Primary Treatment Strategy in Patients with Squamous Cell Carcinoma of the Oropharynx JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 752 OP 757 DO 10.2967/jnumed.107.039610 VO 48 IS 5 A1 Sang Yoon Kim A1 Jong-Lyel Roh A1 Mi Ra Kim A1 Jae Seung Kim A1 Seung-Ho Choi A1 Soon Yuhl Nam A1 Sang-wook Lee A1 Sung-Bae Kim YR 2007 UL http://jnm.snmjournals.org/content/48/5/752.abstract AB High tumor uptake of 18F-FDG is associated with an unfavorable outcome in cancer patients. We evaluated pretreatment 18F-FDG uptake as guidance for the primary treatment modality in patients with squamous cell carcinoma (SCC) of the oropharynx. Methods: Fifty-two consecutive patients with newly diagnosed resectable SCC of the oropharynx underwent 18F-FDG PET before treatment. Primary treatment modalities consisted of surgical resection plus radiotherapy (RT) (surgery group, n = 31) or radical RT plus chemotherapy (RT group, n = 21). The sex, age, tumor stage, histologic grade, TNM classification, treatment strategy, and maximum standardized uptake value (SUV) categories were analyzed for association with local control (LC) and disease-free survival (DFS). The median follow-up of the surviving patients was 36 mo. Results: The median SUV was significantly higher in the 11 patients who failed treatment than that in the remaining controlled patients (8.0 vs. 5.4; P = 0.021). Patients having tumors with a high SUV > 6.0 had poorer LC and DFS (P < 0.05). In multivariate analysis, the SUV remained an independent determinant of LC and DFS (P < 0.05). Patients with a SUV > 6.0 in the surgery group had a higher 3-y DFS than that in the RT group (78% vs. 33%; P = 0.043). Conclusion: Pretreatment tumor 18F-FDG uptake represents an independent prognostic factor in patients with oropharyngeal SCC. Patients with high 18F-FDG uptake may be better treated by surgery followed by RT with or without chemotherapy, which needs to be verified by a prospective randomized study.