Objectives To investigate the role of PET-derived imaging markers in predicting metastatic nasopharyngeal carcinoma (NPC) outcomes.

 Materials and methods A total of 56 patients with metastatic NPC were enrolled. Before treatment, all of the participants underwent 18F-FDG PET/CT. The following 18F-FDG PET parameters were assessed: standardised uptake value, metabolic tumour volume (MTV), and total lesion glycolysis. Multivariate Cox proportional hazards models were used to identify the independent predictors of survival.

 Results The multivariate analysis showed that performance status>1 (P=0.007), Epstein–Barr virus (EBV) DNA titre>5000copies/mL (P=0.001), and MTV>110mL (P=0.013) were independent risk factors for progression-free survival (PFS). Male sex (P=0.004), performance status>1 (P<0.0001), EBV DNA level>5000copies/mL (P<0.0001), and MTV>110mL (P=0.003) independently predicted overall survival (OS). The 2-year PFS and OS rates of the patients with MTV⩽110mL were 23.2% and 43%, respectively, compared with 0% and 9.1%, respectively, for those with MTV>110mL. Combining the MTV with the EBV DNA titre allowed further survival stratification by dividing the patients into three groups with distinct PFS (2-year rates=30.8%, 7.1%, and 0%, P<0.0001) and OS (2-year rates=68.4%, 40%, and 0%, P<0.0001) rates.

 Conclusion The MTV appears to be an independent risk factor in metastatic NPC patients. This factor is complementary to the EBV DNA titre for predicting survival in metastatic NPC.

 Source: Journal of Oral Oncology

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