FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience
| Autor: | Luca Burroni, F. Patani, S. Costantini, Clelia Di Carlo, M. Montisci, F. Fenu, C. Mariucci, Maika di Benedetto, Marco Valenti, Francesca Cucciarelli, L. Vicenzi, Valeria Panni, E. Arena, Andrea Palucci, Giovanna Mantello |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Endoscopic ultrasound Cancer Research medicine.medical_specialty radiotherapy planning anal cancer medicine.medical_treatment target volume definition 03 medical and health sciences 0302 clinical medicine medicine Anal cancer Stage (cooking) RC254-282 Pelvis Original Research medicine.diagnostic_test business.industry 18FDG PET/CT Neoplasms. Tumors. Oncology. Including cancer and carcinogens Magnetic resonance imaging Anal canal medicine.disease Radiation therapy 030104 developmental biology medicine.anatomical_structure Oncology Positron emission tomography 030220 oncology & carcinogenesis dose escalation Radiology business |
| Zdroj: | Frontiers in Oncology Frontiers in Oncology, Vol 11 (2021) |
| ISSN: | 2234-943X |
| DOI: | 10.3389/fonc.2021.655322 |
| Popis: | AimsRadiotherapy with concurrent 5-fluorouracil/mitomycin-C based chemotherapy has been established as definitive standard therapy approach for anal cancer. Intensity Modulated Radiotherapy (IMRT) leads to a precise treatment of the tumor, allowing dose escalation on Gross Tumor Volume (GTV), with a surrounding healthy tissues sparing. Our study assessed the impact of 18-Fluorodeoxyglucose positron emission tomography (18FDG-PET/CT) on the radiotherapy contouring process and its contribution to lymphatic spread detection, resulting to a personalization of Clinical Target Volume (CTV) and dose prescription.MethodsThirty-seven patients, with histologically proven squamous cell carcinoma of the anal canal (SCCAC) were analyzed. All patients were evaluated with history and physical examination, trans-anal endoscopic ultrasound, pelvis magnetic resonance imaging (MRI), computed tomography (CT) scans of the chest, abdomen and pelvis and planning 18FDG-PET/CT. The GTV and CTV were drawn on CT, MRI and 18FDG-PET/CT fused images.ResultsThirty-four (91%) out of 37 patients presented lymph nodes involvement, in one or more areas, detected on 18FDG-PET/CT and/or MRI. The 18FDG-PET/CT showed positive lymph nodes not detected on MRI imaging (PET+, MRI−) in 14/37 patients (38%). In 14 cases, 18FDG-PET/CT allowed to a dose escalation in the involved nodes. The 18FDG-PET/CT fused images led to change the stage in 5/37(14%) cases: four cases from N0 to N1 (inguinal lymph nodes) and in one case from M0 to M1 (common iliac lymph nodes).ConclusionsThe 18FDG-PET/CT has a potentially relevant impact in staging and target volume delineation/definition in patients affected by anal cancer. In our experience, clinical stage variation occurred in 14% of cases. More investigations are needed to define the role of 18FDG-PET/CT in the target volume delineation of anal cancer. |
| Databáze: | OpenAIRE |
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