https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28291 max), metabolic tumour volume (MTV) and total lesional glycolysis (TLG) of primary tumour (PT) and index node (IN) [defined as lymph node(s) with highest TLG] were analysed, and results were correlated with loco-regional recurrence-free survival (LRFS), disease-free survival (DFS), metastatic failure-free survival(MFFS) and overall survival (OS), using Kaplan-Meier analysis. Results: Optimal cutoffs (OC) were derived from receiver operating characteristic curves: SUV_max-PT=4.25 g/mL, MTV_PT=3.3 cm³, TLG_PT=9.4 g, for PT, and SUV_max-IN=4.05 g/mL, MTV_IN=1.85 cm³ and TLG_IN=7.95 g for IN. Low metabolic values in iPET for PT below OC were associated with statistically significant better LRFS and DFS. TLG was the best predictor of outcome with 2-year LRFS of 92.7 % vs. 71.1% [p=0.005, compared with SUV_max (p=0.03) and MTV (p=0.022)], DFS of 85.9% vs. 60.8% [p=0.005, compared with SUV_max (p=0.025) and MTV (p=0.018)], MFFS of 85.9% vs. 83.7% [p=0.488, compared with SUV_max (p=0.52) and MTV (p=0.436)], and OS of 81.1% vs. 75.0% [p=0.279, compared with SUV_max (p=0.345) and MTV (p=0.512)]. There were no significant associations between the percentage reduction of primary tumour metabolic parameters and outcomes. In patients with nodal disease, metabolic parameters below OC (for both PT and IN) were significantly associated with all oncological outcomes, while TLG was again the best predictor: LRFS of 84.0% vs. 55.3% (p=0.017), DFS of 79.4% vs. 38.6% (p=0.001), MFFS 86.4% vs. 68.2% (p=0.034) and OS 80.4% vs. 55.7% (p=0.045). Conclusion: The metabolic parameters of iPET can be useful predictors of patient outcome and potentially have a role in adaptive therapy for MPHNSCC. Among the three parameters, TLG was found to be the best prognostic indicator of oncological outcomes.]]> Wed 11 Apr 2018 10:09:13 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29991 18F-FDG PET-CT performed before definitive radiation therapy (RT) (prePET) in patients with mucosal primary head and neck squamous cell carcinoma (MPHNSCC) and to assess the additive prognostic values of FDG PET-CT performed during RT (iPET). Methods: One hundred patients with MPHNSCC treated with radical RT underwent staging prePET and iPET performed during the third week of treatment. The maximum standardized uptake value (SUV_max), metabolic tumour volume (MTV) and total lesional glycolysis (TLG) of primary tumour were analysed for both prePET and iPET, and results were correlated with loco-regional recurrence-free survival (LRFS), disease-free survival (DFS), metastatic failure-free survival (MFFS) and overall survival (OS), using Kaplan–Meier analysis. Optimal cut-offs (OC) for prePET and iPET were derived from Receiver Operating Characteristic curves. Patients with metabolic parameters above/below the individual OC of prePET as well as iPET (i.e. combined prePET and iPET (comPET)) were evaluated against their outcomes. Results: Median age was 61 years (range 39–81), median follow-up of 20 months (range 4–70, mean 27), and AJCC 7th Edition clinical stage II, III and IV were 8, 24 and 68 patients respectively. Metabolic values below individual OC in comPET were found to be associated with statistically significant improvements (P < 0.05) in DFS, LRFS and OS. In addition, patients with SUV_max above the OC in comPET were associated with worse MFFS (P = 0.011) and confirmed on both univariate (P = 0.019) and multivariate analyses (P = 0.04). Conclusion: Addition of iPET significantly improves the prognostic values of all three metabolic parameters and can potentially be used in future adaptive local and systemic therapy trials.]]> Thu 28 Oct 2021 12:36:43 AEDT ]]>