The Association between the Metabolic Tumor Volume and the Prognosis in Patients with Laryngeal Carcinoma

Abstract

The current definitive treatment for laryngeal cancer is surgery and radiotherapy. Radiotherapy with or without concurrent chemotherapy is used to preserve the function of the organs; however, more than a few patients experience residual or recurrent lesions after radiotherapy-based treatment. Not all such patients undergo salvage surgery, and salvage surgery after irradiation is associated with a high complication rates. A precise prediction of the response to radiotherapy-based treatment is therefore warranted.

We previously reported that the metabolic tumor volume（MTV）, a volumetric parameter of FDG-PET, of a primary tumor was an independent predictive and prognostic factor in laryngeal cancer treated by a radiotherapy-based protocol. Patients with residual disease showed a significantly higher MTV than those with a complete response after primary treatment. According to a multivariate analysis, MTV was found to be an independent prognostic factor for survival.

Next, we evaluated the difference in the survival outcomes of surgery-based and radiotherapy-based treatment in patients with high-MTV laryngeal cancer. Patients with high-MTV laryngeal cancer who were treated by a surgery-based protocol showed better survival than those who underwent radiotherapy-based treatment. These results imply that the MTV could be an important factor when planning the treatment strategy for patients with laryngeal cancer.