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Prognostic value of 18F-FDG-PET/CT in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis

Jie Lin, Guozhu Xie, Guixiang Liao, Baiyao Wang, Miaohong Yan, Hui Li and Yawei Yuan _

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Oncotarget. 2017; 8:33884-33896. https://doi.org/10.18632/oncotarget.13934

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Abstract

Jie Lin1,*, Guozhu Xie1,*, Guixiang Liao3, Baiyao Wang1, Miaohong Yan1, Hui Li1 and Yawei Yuan1,2

1 Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China

2 Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, China

3 Department of Radiation Oncology, Shenzhen people’s Hospital, Second Clinical Medicine College of Jinan University, Guangzhou, Guangdong, China

* These authors have contributed equally to this work

Correspondence to:

Yawei Yuan, email:

Keywords: 18F-FDG PET/CT, standardized uptake value, metabolic tumor volume, total lesion glycolysis, nasopharyngeal carcinoma

Received: July 29, 2016 Accepted: December 06, 2016 Published: December 14, 2016

Abstract

Background: The prognostic role of 18F-fluorodeoxyglucose positron emission tomography CT (18F-FDG PET/CT) parameters is still controversial in nasopharyngeal carcinoma patients. We sought to perform a systematic review and meta-analysis to explore the prognostic value of maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on event-free survival (EFS) and overall survival (OS) in nasopharyngeal carcinoma patients.

Results: Fifteen studies comprising 1,938 patients were included in this study. The combined hazard ratios (HRs) for EFS were 2.63 (95%CI 1.71-4.05) for SUVmax, 2.55 (95%CI 1.49-4.35) for MTV, and 3.32 (95%CI 1.23-8.95) for TLG. The pooled HRs for OS were 2.07 (95%CI 1.54-2.79) for SUVmax, 3.86 (95%CI 1.85-8.06) for MTV, and 2.60 (95%CI 1.55-4.34) for TLG. The prognostic role of SUVmax, MTV and TLG remained similar in the sub-group analyses.

Methods: A systematic literature search was performed to identify studies which associated 18F-FDG PET/CT to clinical survival outcomes of nasopharyngeal carcinoma patients. The summarized HRs for EFS and OS were estimated by using fixed- or random-effect models according to heterogeneity between trials.

Conclusions: The present meta-analysis confirms that high values of SUVmax, MTV and TLG predicted a higher risk of adverse events or death in patients with nasopharyngeal carcinoma, despite clinically heterogeneous nasopharyngeal carcinoma patients and the various methods adopted between these studies.


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