Prognostic Factors in Patients Treated with 223Ra: The Role of Skeletal Tumor Burden on Baseline 18F-Fluoride PET/CT in Predicting Overall Survival
| Autor: | John C. Araujo, Nancy Swanston, Elba Etchebehere, Patricia S. Fox, Eric M. Rohren, Homer A. Macapinlac |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
PET-CT business.industry Hazard ratio Urology Standardized uptake value Odds ratio medicine.disease Confidence interval chemistry.chemical_compound Prostate cancer chemistry medicine Clinical endpoint Radiology Nuclear Medicine and imaging Nuclear medicine business Fluoride |
| Zdroj: | Journal of Nuclear Medicine. 56:1177-1184 |
| ISSN: | 2159-662X 0161-5505 |
| DOI: | 10.2967/jnumed.115.158626 |
| Popis: | The purpose of this study was to evaluate outcome after 223Ra dichloride therapy (223Ra) and to determine whether skeletal tumor burden on whole-body 18F-fluoride PET/CT can be used as a predictive biomarker of survival in patients treated with 223Ra. Methods: Forty-two patients with hormone-refractory prostate cancer underwent 223Ra and a baseline fluoride PET/CT scan. Fluoride PET/CT parameters were generated, including maximum standardized uptake value (SUVmax) of the hottest lesion (hSUVmax), average SUV of disease (Mean10), and skeletal tumor burden indices of total fluoride skeletal metastatic lesion uptake (TLF10) and total volume of fluoride avid bone metastases (FTV10). Overall survival (OS) was the primary endpoint. Secondary endpoints were progression-free survival and skeletal-related event (SRE). Results: Skeletal tumor burden indices (TLF10 and FTV10) derived from fluoride PET/CT at baseline were highly correlated and significant independent predictors of OS (P = 0.0212; hazard ratio = 5.990; 95% confidence interval = 1.306–27.475). A TLF10 cutoff value of 8,000 discriminated survivors from nonsurvivors after 223Ra (with TLF10 values 8,000, the median OS was 6.67 mo). Visual analysis, Mean10, and hSUVmax were not predictors of OS or progression-free survival. Mean10 was found to be a significant univariate predictor of the odds of having an SRE (P = 0.0445; odds ratio = 1.30; 95% confidence interval = 1.006–1.681), with a Mean10 greater than 19 increasing the risk of SRE. Conclusion: Skeletal tumor burden on baseline fluoride PET/CT is a predictive biomarker of OS and the risk of an SRE in patients treated with 223Ra. |
| Databáze: | OpenAIRE |
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