Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas

Abstract Introduction To identify the subset of patients with de novo nasopharyngeal carcinoma (NPC) for whom [18F] fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) should be recommended, and to determine whether PET/CT is a cost-effective decision for precise...

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Autores principales:	Chuanben Chen, Ting Xu, Xiufang Qiu, Shihan Xie, Ziqing You, Yixin Hu, Yinghong Zheng, Zewei Liang, Chaoxiong Huang, Taojun Chen, Li Li, Jing Liu, Zhaodong Fei
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Nasopharyngeal carcinoma [18F] Fluorodeoxyglucose positron emission tomography Metastasis Economic evaluation Cost-effectiveness analysis Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/88f0070002284f608c9628ad14d39586
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spelling	oai:doaj.org-article:88f0070002284f608c9628ad14d395862021-11-28T12:13:55ZSelectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas10.1186/s13014-021-01954-81748-717Xhttps://doaj.org/article/88f0070002284f608c9628ad14d395862021-11-01T00:00:00Zhttps://doi.org/10.1186/s13014-021-01954-8https://doaj.org/toc/1748-717XAbstract Introduction To identify the subset of patients with de novo nasopharyngeal carcinoma (NPC) for whom [18F] fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) should be recommended, and to determine whether PET/CT is a cost-effective decision for precise M staging in endemic areas. Materials and methods Retrospective analysis of data of 4469 patients diagnosed with de novo NPC between January 2014 and December 2019. The detection rate of distant metastasis was compared between different groups. Univariate and multiple logistic regression analysis was applied to identify the risk factors for distant metastasis. The cost-effectiveness of the diagnostic strategies was assessed. Results The detection rate of distant metastasis in the whole cohort was 5.46%. In multivariate analysis, male sex, T3-4 stage, N2-3 stage, and high plasma Epstein-Barr virus (EBV) DNA (≥ 14,650 copies/mL) were risk factors for distant metastases. NPC patients with T3-4 stage combined with N2-3 stage, high EBV DNA combined with male sex, or N2-3 stage combined with high EBV DNA were defined as recommended group with relatively higher tendency for metastasis. Distant metastasis incidence in recommended group and unrecommended group were 10.25% and 1.75%, respectively (P < 0.001). In the recommended group, PET/CT significantly improved the detection rate of distant metastasis (13.25% vs 9.02%, P = 0.005). Cost-effectiveness analysis revealed that additional cost for every one percent increase in distant metastasis detection rate was $22,785.58 in the recommended group (< Willingness-to-pay (WTP) threshold of $32,700.00) and $310,912.90 in the unrecommended group. Conclusions In patients with de novo NPC, the tendency for metastasis can be predicted based on clinical parameters. 18F-FDG PET/CT should be selectively recommended for the subset of patients with a relatively higher tendency for metastasis.Chuanben ChenTing XuXiufang QiuShihan XieZiqing YouYixin HuYinghong ZhengZewei LiangChaoxiong HuangTaojun ChenLi LiJing LiuZhaodong FeiBMCarticleNasopharyngeal carcinoma[18F] Fluorodeoxyglucose positron emission tomographyMetastasisEconomic evaluationCost-effectiveness analysisMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENRadiation Oncology, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Nasopharyngeal carcinoma [18F] Fluorodeoxyglucose positron emission tomography Metastasis Economic evaluation Cost-effectiveness analysis Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Nasopharyngeal carcinoma [18F] Fluorodeoxyglucose positron emission tomography Metastasis Economic evaluation Cost-effectiveness analysis Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Chuanben Chen Ting Xu Xiufang Qiu Shihan Xie Ziqing You Yixin Hu Yinghong Zheng Zewei Liang Chaoxiong Huang Taojun Chen Li Li Jing Liu Zhaodong Fei Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas
description	Abstract Introduction To identify the subset of patients with de novo nasopharyngeal carcinoma (NPC) for whom [18F] fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) should be recommended, and to determine whether PET/CT is a cost-effective decision for precise M staging in endemic areas. Materials and methods Retrospective analysis of data of 4469 patients diagnosed with de novo NPC between January 2014 and December 2019. The detection rate of distant metastasis was compared between different groups. Univariate and multiple logistic regression analysis was applied to identify the risk factors for distant metastasis. The cost-effectiveness of the diagnostic strategies was assessed. Results The detection rate of distant metastasis in the whole cohort was 5.46%. In multivariate analysis, male sex, T3-4 stage, N2-3 stage, and high plasma Epstein-Barr virus (EBV) DNA (≥ 14,650 copies/mL) were risk factors for distant metastases. NPC patients with T3-4 stage combined with N2-3 stage, high EBV DNA combined with male sex, or N2-3 stage combined with high EBV DNA were defined as recommended group with relatively higher tendency for metastasis. Distant metastasis incidence in recommended group and unrecommended group were 10.25% and 1.75%, respectively (P < 0.001). In the recommended group, PET/CT significantly improved the detection rate of distant metastasis (13.25% vs 9.02%, P = 0.005). Cost-effectiveness analysis revealed that additional cost for every one percent increase in distant metastasis detection rate was $22,785.58 in the recommended group (< Willingness-to-pay (WTP) threshold of $32,700.00) and $310,912.90 in the unrecommended group. Conclusions In patients with de novo NPC, the tendency for metastasis can be predicted based on clinical parameters. 18F-FDG PET/CT should be selectively recommended for the subset of patients with a relatively higher tendency for metastasis.
format	article
author	Chuanben Chen Ting Xu Xiufang Qiu Shihan Xie Ziqing You Yixin Hu Yinghong Zheng Zewei Liang Chaoxiong Huang Taojun Chen Li Li Jing Liu Zhaodong Fei
author_facet	Chuanben Chen Ting Xu Xiufang Qiu Shihan Xie Ziqing You Yixin Hu Yinghong Zheng Zewei Liang Chaoxiong Huang Taojun Chen Li Li Jing Liu Zhaodong Fei
author_sort	Chuanben Chen
title	Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas
title_short	Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas
title_full	Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas
title_fullStr	Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas
title_full_unstemmed	Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas
title_sort	selectively recommend 18f-fdg pet/ct for patients with de novo nasopharyngeal carcinoma in endemic areas
publisher	BMC
publishDate	2021
url	https://doaj.org/article/88f0070002284f608c9628ad14d39586
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Selectively recommend 18F-FDG PET/CT for patients with de novo nasopharyngeal carcinoma in endemic areas

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