ESTRO 36 Abstract Book

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S582 ESTRO 36
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2 University Hospital Maggiore della Carità, Nuclear
Medicine, Novara, Italy
3 University Hospital Maggiore della Carità, Medical
Physics, Novara, Italy
Purpose or Objective
To evaluate the predictive and prognostic value of [F18]
FDG-PET parameters performed prior to radiotherapy in
head-and-neck cancer patients.
Material and Methods
Thirty-eight patients with newly diagnosed head-and-neck
cancer treated with concomitant chemoradiotherapy
underwent [F18] FDG-PET before the treatment course.
The maximum and the mean standardized uptake value
(SUVmax, SUVmean), the metabolic tumor volume (MTV),
and total lesion glycolysis (TLG) were analysed. Multiple
threshold levels were tested in order to define the most
suitable threshold value for the metabolic activity of each
patient's tumour: the fixed threshold of the 41% and 50%
of the maximum uptake value (SUV41%, SUV50%) and an
adaptive threshold algorithm (ATA) implemented on the
iTaRT workstation (Tecnologie Avanzate, Italy). We
evaluated the relationship of mean values of SUVmax,
SUVmean, MTV, and TLG with tumour characteristics,
treatment response, local recurrence, distant metastasis
and disease-related death. Receiver-operating
characteristic (ROC) curve analysis was done to obtain
optimal predictive cut-off values for PET parameters.
Disease-free (DFS) and overall survival (OS) disease-
related were examined according to these cut-offs.
Results
The mean value and range of each parameters were
calculated (Table1).
Higher SUVmeanATA was associated to higher primary
tumour staging (p= 0.04).
Thirty-two/38 patients (84.2%) had a complete response,
4/38 (10.5%) a partial response, and 2/38 (5.2%) a no
response 8 weeks after the completion of treatment. SUV
parameters resulted not predictive of tumour response.
After a median follow-up of 22 months, 6/38 (15.8%)
patients developed local recurrence and 6/38 (15.8%)
distant relapse. Eight patients (21.1%) died of tumour
progression.
The TLGATA was predictive of local recurrence (p = 0.04).
ROC curves analysis revealed a cut-off value of 19.6 for
SUVmax, and 13.7 for SUVmean ATA (AUC 0.72, p=0.03 and
AUC 0.72 p=0.03, respectively). The 2-year DFS rate was
significantly lower in patients with a SUVmax >19.6 (p=
0.001) and with a SUVmean ATA >13.7 (p= 0.02).
ROC curves analysis revealed a cut-off value of 19.6 for
SUVmax, 8.6 for SUVmeanATA and 49.1 for TLGATA (AUC 0.8,
p=0.03; AUC 0.9 p=0.007, and AUC 0.8 p= 0.01
respectively). The 2-year OS rate was significantly lower
in patients with a SUVmax >19.6 (p= 0.004), with a
SUVmeanATA >8.6 (p= 0.03) and TLGATA >49.1 (p= 0.004).
Table 1. [18F] FDG-PET paramenters based on multiple
threshold levels.
Parameters
SUVmax SUVmean MTV
(cc) TLG
Adaptive
threshold
algorithm (ATA)
16.37
(4.41 –
34.53)
9.15 (2.8 –
19.71)
17.21
(1.5 –
61.53)
149.89
(5.3 –
877.85)
SUV41%
16.37
(4.41 –
34.53)
10.50
(2.94 –
21.78)
10.30
(1.02 –
58)
130.90
(3 –
850.86)
SUV50%
16.37
(4.41 –
34.53)
11.45
(3.33 –
23.73)
7.79
(0.45 –
47.11)
107.77
(2.10 –
736.33)
Conclusion
Adaptive threshold-based SUVmean, MTV, and TLG and
SUVmax could have a role in predicting local control and
survival in head and neck cancer patients treated with
chemoradiotherapy.
EP-1058 A multicenter study of carbon-io n RT for
locally advanced olfactory neuroblastomas (J-
CROS1402HN)
H. Suefuji1, M. Koto 2, Y. Demizu3, J. Saitoh4, Y.
Shioyama1, H. Tsuji2, T. Okimoto3, T. Ohno4, K. Nemoto5,
T. Nakano4, T. Kamada2
1Ion Beam Therapy Center- SAGA-HIMAT Foundation,
radiation oncology, tosu, Japan
2National Institute of Radiological Science Hospital-
National Institutes for Quantum and Radiological
Sciences and Technology, radiation oncology, chiba,
Japan
3Hyogo Ion Beam Medical Center, radiology, tatsuno,
Japan
4Gunma University Heavy Ion Medical Center, radiology,
maebashi, Japan
5Yamagata University Faculty of Medicine, radiation
oncology, yamagata, Japan
Purpose or Objective
The combination with surgery and postoperative
radiotherapy is the most common therapy for locally
advanced olfactory neuroblastomas (ONB), but has a high
incidence of local analyzed the ONB
patients treated by carbon-ion radiotherapy (C-ion RT) in
the Japan Carbon Ion Radiotherapy Study Group study. In
this study, we evaluated the efficacy and safety of C-ion
RT for locally advanced ONBs in Japan.
Material and Methods
Patients with T4N0-1M0 ONBs who were treated with C-ion
RT at 4 institutions in Japan between November 2003 and
December 2014 were analyzed retrospectively. A total of
twenty-one patients (16 male and 5 female; median age,
53 years) with locally advanced ONBs were enrolled in this
study.
Results
Main tumor sites included the nasal cavity in 11 patients
and sphenoid sinuses in 10, respectively. Seven patients
had T4a and 14 had T4b tumors. All 21 patients enrolled
in this study did not have cervical node metastases. The
median total dose and number of fractions were 60.8 Gy
(RBE) and 16 fractions, respectively. Four patients
received neo-adjuvant chemotherapy. The median follow-
up period was 39 months (range, 5–111 months). The 3
year overall survival and local control rates were 88.4%
and 83.0%, respectively. Grade 4 late toxicity was
observed in 3 patients . Of the three patients, 2 developed
ipsilateral optic nerve disorder and 1ipsilateral
retinopathy. With respect to these patients whose adverse
events could not be avoided, the GTV was over 34cc and
the tumors were in close proximity to the orbit. Except
eye disorder, grade≧ 4 late toxicities did not occurred.
Conclusion
C-ion RT is an effective treatment modality for locally
advanced ONB.
EP-1059 A [18F] FDG-PET adaptive thresholding
algorithm for delineation of RT volumes of
head&neck cancer.
M. Paolini1, L. Deantonio1, L. Vigna 2, R. Matheoud2, G.
Loi2, G. Sacchetti3, M. Brambilla2, M. Krengli1
1University Hospital Maggiore della Carità,
Radiotherapy, Novara, Italy
2University Hospital Maggiore della Carità, Medical
Physics, Novara, Italy
3University Hospital Maggiore della Carità, Nuclear
Medicine, Novara, Italy