Prognostic value of 18F-FDG-PET/CT in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis

// Jie Lin 1,* , Guozhu Xie 1,* , Guixiang Liao 3 , Baiyao Wang 1 , Miaohong Yan 1 , Hui Li 1 and Yawei Yuan 1,2 1 Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China 2 Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, China 3 Department of Radiation Oncology, Shenzhen people’s Hospital, Second Clinical Medicine College of Jinan University, Guangzhou, Guangdong, China * These authors have contributed equally to this work Correspondence to: Yawei Yuan, email: // Keywords : 18F-FDG PET/CT, standardized uptake value, metabolic tumor volume, total lesion glycolysis, nasopharyngeal carcinoma Received : July 29, 2016 Accepted : December 06, 2016 Published : December 14, 2016 Abstract Background: The prognostic role of 18 F-fluorodeoxyglucose positron emission tomography CT ( 18 F-FDG PET/CT) parameters is still controversial in nasopharyngeal carcinoma patients. We sought to perform a systematic review and meta-analysis to explore the prognostic value of maximal standardized uptake value (SUV max ), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on event-free survival (EFS) and overall survival (OS) in nasopharyngeal carcinoma patients. Results: Fifteen studies comprising 1,938 patients were included in this study. The combined hazard ratios (HRs) for EFS were 2.63 (95%CI 1.71-4.05) for SUV max , 2.55 (95%CI 1.49-4.35) for MTV, and 3.32 (95%CI 1.23-8.95) for TLG. The pooled HRs for OS were 2.07 (95%CI 1.54-2.79) for SUV max , 3.86 (95%CI 1.85-8.06) for MTV, and 2.60 (95%CI 1.55-4.34) for TLG. The prognostic role of SUV max , MTV and TLG remained similar in the sub-group analyses. Methods: A systematic literature search was performed to identify studies which associated 18 F-FDG PET/CT to clinical survival outcomes of nasopharyngeal carcinoma patients. The summarized HRs for EFS and OS were estimated by using fixed- or random-effect models according to heterogeneity between trials. Conclusions: The present meta-analysis confirms that high values of SUV max , MTV and TLG predicted a higher risk of adverse events or death in patients with nasopharyngeal carcinoma, despite clinically heterogeneous nasopharyngeal carcinoma patients and the various methods adopted between these studies.