Abstract / Description
AimThis study evaluated the prognostic value of 18F-Fluorodeoxyglucose (18F-FDG) uptake in tumour and adipose tissue in recurrent or metastatic (R/M) nasopharyngeal carcinoma (NPC) patients treated with immunotherapy.Materials and methodsWe retrospectively included 120 patients with R/M NPC treated with PD-1 inhibitors. Maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) of all malignant lesions were recorded. Additionally, SUVmax and SUVmean were measured for subcutaneous and visceral adipose tissue (SAT and VAT). The study classified patients who, within six months of immunotherapy, either experienced tumour progression, died, or changed treatment regimens as the nonclinical benefit (non-CB) group, and others as the CB group. The primary endpoints were progression-free survival (PFS) and overall survival (OS).ResultsThe CB group had significantly lower primary tumour MTV (PT-MTV) (median, 15.8 vs 48.1, P=0.006), PT-TLG (median, 88.7 vs 275.6, P=0.008) and SUVmax-VAT (median, 0.63 vs 0.77, P=0.047) than non-CB group. More T4 stages (71.4% vs. 41.3%) and lung metastases (42.9% vs 21.7%) were observed in the non-CB group compared to the CB group. Multivariate analysis indicated lung metastases (P=0.002, hazard ratio [HR] = 2.204, 95% confidence interval [CI]: 1.323-3.669) and higher primary tumour burden (P