GÖRKEM ESKİİZMİR, GÜLGÜN YILMAZ OVALI, Feray ARAS, BEYHAN CENGİZ ÖZYURT, SERDAR TARHAN

Predictive and prognostic values of pretreatment functional imaging-based biomarkers in advanced-stage laryngeal cancer

Objective: To determine the quantitative values of apparent diffusion coefficient (ADC), standardized uptake values(SUVmax, SUVmean), metabolic tumor volume (MTV), metabolic tumor volume indexes (MTImax, and MTImean) using diffusion weighted-MRI (DW-MRI) and positron emission tomography/computed tomography (PET/CT), and analyze the predictive and prognostic values of these biomarkers in a homogenous group of patients with advanced-stage laryngeal cancer. Methods: Patients with newly diagnosed advanced-stage laryngeal cancer who had both DW-MRI and 18F-FDG PET/CT before treatment, and who had curative cancer treatment (surgery ± adjuvant therapy or radio ± chemotherapy) between 2011 and 2015 were included in this study. All patients were followed up clinically and radiologically, if necessary every 3 months for the first 2 years, every 4–6 months for year 3, and then annually thereafter. Results: Thirty-eight patients were retrospectively analyzed. Our analysis demonstrated statistically significant differences when the pretreatment SUV and MTImean value were compared between patients with stages III and IV. Standardized uptake value was also a predictive factor for N-stage. Moreover, a statistically significant difference was determined when patients with and without perinodal involvement (PNI) were compared. Log rank analysis demonstrated that none of functional imaging-based biomarkers had a prognostic role for oncological outcomes. Conclusion: Our results demonstrated that pretreatment SUV and MTImean values were predictive factors for staging, N-stage and PNI. Indeed, functional imaging-based biomarkers are promising, novel, noninvasive techniques that may provide additional information about tumor characteristics, treatment selection and prognosis in the near future.

‹leri evre larenks kanserinde tedavi öncesi fonksiyonel görüntülemeye dayal› biyobelirteçlerin öngördürücü ve prognostik de¤eri

Amaç: Difüzyon a¤›rl›kl› MR görüntüleme (DW-MRI) ve pozitron emisyon tomografi/bilgisayarl› tomografiyi (PET/BT) kullanarak görünür difüzyon katsay›s›n›n (ADC) nicel de¤erleri, standardize edilmiﬂ tutulum de¤eri (SUVmaks, SUVort), metabolik tümör volümü (MTV), metabolik tümör volüm göstergelerini (MTImaks ve MTIort)belirlemek ve ileri evre larenks kanserli homojen hasta grubunda bu biyobelirteçlerin öngördürücü ve prognostik de¤erlerini incelemektir. Yöntem: Yeni tan› konmuﬂ ileri evre larenks kanserli, tedavi öncesi hem DW-MRI hem de 18F-FDG PET/BT çektirmiﬂ ve 2011–2015 y›llar› aras›nda küratif kanser tedavisi görmüﬂ (cerrahi ± adjuvan tedavi veya radyoterapi ± kemoterapi) hastalar çal›ﬂmaya dahil edildi. Hastalar›n tümü gerekti¤inde ilk 2 y›l 3 ayda bir, 3. y›l 4–6 ayda bir ve daha sonra y›lda bir klinik ve radyolojik olarak izlendi. Bulgular: Otuz sekiz hasta geriye dönük olarak incelendi. ‹ncelememiz evre III ve IV hastalar aras›nda tedavi öncesi SUV ve MTIort de¤erleri aç›s›ndan istatistiksel aç›dan anlaml› farkl›l›klar oldu¤unu gösterdi. Standardize edilmiﬂ tutulum de¤eri evresi de N-evresi için bir öngördürücü faktördü. Ayr›ca perinodal tutulumu (PNT) olan ve olmayan hastalar aras›nda da istatistiksel aç›dan anlaml› farkl›l›k olduğu belirlendi. Logaritmik s›ralama çözümlemesi, fonksiyonel görüntülemeye dayal› biyobelirteçlerin hiçbirisinin onkolojik sonuçlar aç›s›ndan prognostik role sahip olmad›¤›n› gösterdi. Sonuç: Bulgular›m›z tedavi öncesi SUV ve MTIort de¤erlerinin evreleme, N-evresi ve PNT aç›s›ndan öngördürücü faktörler oldu¤unu göstermiﬂtir. Gerçekten de fonksiyonel görüntülemeye dayal› biyobelirteçler tümörün özellikleri, tedavi seçimi ve yak›n dönem prognozu hakk›nda ek bilgi sa¤layan umut verici, yeni ve giriﬂimsel olmayan tekniklerdir.

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