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

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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.

Original languageEnglish
JournalRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Issue number3
Pages (from-to)360-5
Number of pages6
Publication statusPublished - Jun 2014

    Research areas

  • 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

ID: 44921255