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Abstract
<jats:p><p>Top row: Squamous cell carcinoma with high pre-treatment total lesion glycolysis (TLG) on FDG PET. Following mid-treatment response and a standard 60Gy (non-boosted) plan, the patient developed locoregional progression (LRP) within 1 year, suggesting high pre-treatment TLG confers elevated LRP risk. They also developed distant metastatic progression (DM) within 1 year, which was correlated with high residual mid-treatment TLG. Bottom row: Adenocarcinoma with relatively low pre-treatment TLG and high residual mid-treatment TLG on FDG PET. A boost plan (74–90Gy) was delivered for non-response and resulted in no LRP event, yet the patient developed distant metastatic progression (DM) within 1 year, suggesting high mid-treatment TLG confers elevated DM risk.</p></jats:p>