Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake

Anne K Due; Ivan R Vogelius; Marianne C Aznar; Søren M Bentzen; Anne K Berthelsen; Stine S Korreman; Annika Loft; Claus A Kristensen; Lena Specht

doi:10.1016/j.radonc.2014.06.001

Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake

Anne K Due, Ivan R Vogelius, Marianne C Aznar, Søren M Bentzen, Anne K Berthelsen, Stine S Korreman, Annika Loft, Claus A Kristensen, Lena Specht

Afdeling for Klinisk Fysiologi og Nuklearmedicin DIA

107 Citationer (Scopus)

Abstract

BACKGROUND AND PURPOSE: 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.

MATERIAL AND METHODS: 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.

RESULTS: 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).

CONCLUSIONS: The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor.

Originalsprog	Engelsk
Tidsskrift	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Vol/bind	111
Udgave nummer	3
Sider (fra-til)	360-5
Antal sider	6
ISSN	0167-8140
DOI	https://doi.org/10.1016/j.radonc.2014.06.001
Status	Udgivet - jun. 2014

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10.1016/j.radonc.2014.06.001

Citationsformater

Due, A. K., Vogelius, I. R., Aznar, M. C., Bentzen, S. M., Berthelsen, A. K., Korreman, S. S., Loft, A., Kristensen, C. A., & Specht, L. (2014). Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 111(3), 360-5. https://doi.org/10.1016/j.radonc.2014.06.001

Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake. / Due, Anne K; Vogelius, Ivan R; Aznar, Marianne C et al.
I: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, Bind 111, Nr. 3, 06.2014, s. 360-5.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Due, AK, Vogelius, IR, Aznar, MC, Bentzen, SM, Berthelsen, AK, Korreman, SS, Loft, A , Kristensen, CA & Specht, L 2014, 'Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, bind 111, nr. 3, s. 360-5. https://doi.org/10.1016/j.radonc.2014.06.001

Due AK, Vogelius IR, Aznar MC, Bentzen SM, Berthelsen AK, Korreman SS et al. Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2014 jun.;111(3):360-5. doi: 10.1016/j.radonc.2014.06.001

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title = "Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake",

abstract = "BACKGROUND AND PURPOSE: 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.MATERIAL AND METHODS: 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.RESULTS: 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).CONCLUSIONS: The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor.",

keywords = "Carcinoma, Squamous Cell, Fluorodeoxyglucose F18, Head and Neck Neoplasms, Humans, Multimodal Imaging, Neoplasm Recurrence, Local, Positron-Emission Tomography, Radiopharmaceuticals, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Intensity-Modulated, Tomography, X-Ray Computed",

author = "Due, {Anne K} and Vogelius, {Ivan R} and Aznar, {Marianne C} and Bentzen, {S{\o}ren M} and Berthelsen, {Anne K} and Korreman, {Stine S} and Annika Loft and Kristensen, {Claus A} and Lena Specht",

year = "2014",

month = jun,

doi = "10.1016/j.radonc.2014.06.001",

language = "English",

volume = "111",

pages = "360--5",

journal = "Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology",

issn = "0167-8140",

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number = "3",

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TY - JOUR

T1 - Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake

AU - Due, Anne K

AU - Vogelius, Ivan R

AU - Aznar, Marianne C

AU - Bentzen, Søren M

AU - Berthelsen, Anne K

AU - Korreman, Stine S

AU - Loft, Annika

AU - Kristensen, Claus A

AU - Specht, Lena

PY - 2014/6

Y1 - 2014/6

N2 - BACKGROUND AND PURPOSE: 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.MATERIAL AND METHODS: 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.RESULTS: 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).CONCLUSIONS: The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor.

AB - BACKGROUND AND PURPOSE: 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.MATERIAL AND METHODS: 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.RESULTS: 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).CONCLUSIONS: The detailed pattern-of-failure data analysis suggests that most recurrences occur in the FDG PET positive areas or the solid tumor.

KW - Carcinoma, Squamous Cell

KW - Fluorodeoxyglucose F18

KW - Head and Neck Neoplasms

KW - Humans

KW - Multimodal Imaging

KW - Neoplasm Recurrence, Local

KW - Positron-Emission Tomography

KW - Radiopharmaceuticals

KW - Radiotherapy Planning, Computer-Assisted

KW - Radiotherapy, Intensity-Modulated

KW - Tomography, X-Ray Computed

U2 - 10.1016/j.radonc.2014.06.001

DO - 10.1016/j.radonc.2014.06.001

M3 - Journal article

C2 - 24993331

SN - 0167-8140

VL - 111

SP - 360

EP - 365

JO - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

IS - 3

ER -

Recurrences after intensity modulated radiotherapy for head and neck squamous cell carcinoma more likely to originate from regions with high baseline [18F]-FDG uptake

Abstract

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