Anal cancer chemoradiotherapy outcome prediction using 18 F-fluorodeoxyglucose positron emission tomography and clinicopathological factors.

Autor: Rusten E; 1 Department of Medical Physics, University of Oslo , Oslo , Norway., Rekstad BL; 1 Department of Medical Physics, University of Oslo , Oslo , Norway., Undseth C; 2 Department of Oncology, University of Oslo , Oslo , Norway., Klotz D; 3 Department of Pathology, University of Oslo , Oslo , Norway., Hernes E; 4 Department of Nuclear Medicine, University of Oslo , Oslo , Norway., Guren MG; 2 Department of Oncology, University of Oslo , Oslo , Norway.; 5 K.G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital , Oslo , Norway., Malinen E; 1 Department of Medical Physics, University of Oslo , Oslo , Norway.; 6 Department of Physics, University of Oslo , Oslo , Norway.
Jazyk: angličtina
Zdroj: The British journal of radiology [Br J Radiol] 2019 May; Vol. 92 (1097), pp. 20181006. Date of Electronic Publication: 2019 Mar 11.
DOI: 10.1259/bjr.20181006
Abstrakt: Objective: To assess the role of [ 18 F]fluorodeoxyglucose (FDG) positron emission tomography (PET), obtained before and during chemoradiotherapy, in predicting locoregional failure relative to clinicopathological factors for patients with anal cancer.
Methods: 93 patients with anal squamous cell carcinoma treated with chemoradiotherapy were included in a prospective observational study (NCT01937780). FDG-PET/CT was performed for all patients before treatment, and for a subgroup ( n = 39) also 2 weeks into treatment. FDG-PET was evaluated with standardized uptake values (SUV max/peak/mean ), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and a proposed Z-normalized combination of MTV and SUV peak (ZMP). The objective was to predict locoregional failure using FDG-PET, tumor and lymph node stage, gross tumor volume (GTV) and human papilloma virus (HPV) status in univariate and bivariate Cox regression analysis.
Results: N3 lymph node stage, HPV negative tumor, GTV, MTV, TLG and ZMP were in univariate analysis significant predictors of locoregional failure ( p < 0.01), while SUV max/peak/mean were not ( p > 0.2). In bivariate analysis HPV status was the most independent predictor in combinations with N3 stage, ZMP, TLG, and MTV ( p < 0.02). The FDG-PET parameters at 2 weeks into radiotherapy decreased by 30-40 % of the initial values, but neither absolute nor relative decrease improved the prediction models.
Conclusion: Pre-treatment PET parameters are predictive of chemoradiotherapy outcome in anal cancer, although HPV negativity and N3 stage are the strongest single predictors. Predictions can be improved by combining HPV with PET parameters such as MTV, TLG or ZMP. PET 2 weeks into treatment does not provide added predictive value.
Advances in Knowledge: Pre-treatment PET parameters of anal cancer showed a predictive role independent of clinicopathological factors. Although the PET parameters show substantial reduction from pre- to mid-treatment, the changes were not predictive of chemoradiotherapy outcome.
Databáze: MEDLINE
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