Positron Emission Tomography-Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy.

Autor: Greco C; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Pares O; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Pimentel N; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Louro V; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Morales J; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Nunes B; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Antunes I; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Vasconcelos AL; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Kociolek J; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Castanheira J; Department of Nuclear Medicine-Radiopharmacology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Oliveira C; Department of Nuclear Medicine-Radiopharmacology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Silva A; Department of Nuclear Medicine-Radiopharmacology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Vaz S; Department of Nuclear Medicine-Radiopharmacology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Oliveira F; Department of Nuclear Medicine-Radiopharmacology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Carrasquinha E; Computational Clinical Imaging Group, Champalimaud Centre for the Unknown, Lisbon, Portugal., Costa D; Department of Nuclear Medicine-Radiopharmacology, Champalimaud Centre for the Unknown, Lisbon, Portugal., Fuks Z; Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal.; Memorial Sloan Kettering Cancer Center, New York, New York.
Jazyk: angličtina
Zdroj: Advances in radiation oncology [Adv Radiat Oncol] 2021 Dec 05; Vol. 7 (2), pp. 100864. Date of Electronic Publication: 2021 Dec 05 (Print Publication: 2022).
DOI: 10.1016/j.adro.2021.100864
Abstrakt: Purpose: Early positron emission tomography-derived metrics post-oligometastasis radioablation may predict impending local relapses (LRs), providing a basis for a timely ablation.
Methods and Materials: Positron emission tomography data of 623 lesions treated with either 24 Gy single-dose radiation therapy (SDRT) (n = 475) or 3 ×  9 Gy stereotactic body radiation therapy (SBRT) (n = 148) were analyzed in a training data set (n = 246) to obtain optimal cutoffs for pretreatment maximum standardized uptake value (SUV max ) and its 3-month posttreatment decline (ΔSUV max ) in predicting LR risk, validated in a data set unseen to testing (n = 377).
Results: At a median of 21.7 months, 91 lesions developed LRs: 39 of 475 (8.2%) after SDRT and 52 of 148 (35.1%) after SBRT. The optimal cutoff values were 12 for SUV max and -75% for ΔSUV max . Bivariate SUV max /ΔSUV max permutations rendered a 3-tiered LR risk stratification of dual-favorable (low risk), 1 adverse (intermediate risk) and dual-adverse (high risk). Actuarial 5-year local relapse-free survival rates were 93.9% versus 89.6% versus 57.1% ( P < .0001) and 76.1% versus 48.3% versus 8.2% ( P < .0001) for SDRT and SBRT, respectively. The SBRT area under the ROC curve was 0.71 (95% CI, 0.61-0.79) and the high-risk subgroup yielded a 76.5% true positive LR prediction rate.
Conclusions: The SBRT dual-adverse SUV max /ΔSUV max category LR prediction power provides a basis for prospective studies testing whether a timely ablation of impending LRs affects oligometastasis outcomes.
(© 2021 The Authors.)
Databáze: MEDLINE
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