Immunohistochemical Studies and FDG Uptake on PET in Pharyngeal Cancer for Predicting Radiotherapy-based Treatment Outcomes

Abstract

Objectives

This study correlated immunohistochemical studies with fluorodeoxyglucose (FDG) uptake on positron emission tomography–computed tomography (PET–CT) and identified prognostic factors for radiotherapy (RT)-based treatment outcomes in patients with squamous cell carcinoma of the oropharynx and hypopharynx.

Methods

Genomic data from pretreatment biopsy specimens (Glut1, CAIX, VEGF, HIF-1α, EGFR, Ki-67, Bcl-2, CLAUDIN-4, YAP-1, c-Met, and p16) of 76 patients were analyzed using tissue microarrays. FDG uptake was evaluated using the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG).

Results

The overexpression of Glut1 positively associated with increased values of the SUVmax, MTV, and TLG, whereas VEGF and HIF-1α expression with the MTV and TLG, respectively. A VEGF immunoreactive score (IRS) >2 (P = .001, hazard ratio [HR] = 3.94) and an MTV defined by an SUV of 2.5 (MTV2.5) >14.5 mL (P = .004, HR = 3.31) were prognostic factors for low cause-specific survival, whereas a VEGF IRS >2 (P = .02, HR = 2.83) for low primary-relapse free survival.

Conclusion

The overexpression of Glut1, VEGF, and HIF-1α associated with increased FDG uptake. For patients with pharyngeal cancer requiring RT, the treatment outcome can be stratified by VEGF and MTV2.5.

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