18F-FDG-PET/CT Imaging as an early survival predictor in patients with primary high-grade soft tissue sarcomas undergoing neoadjuvant therapy
Autor: | Fritz C. Eilber, Tibor Schuster, Wolfgang Weber, Jeffrey J. Eckardt, Matthias R. Benz, Ken Herrmann, Martin Allen-Auerbach, Michael E. Phelps, Johannes Czernin, William D. Tap, Sarah M. Dry |
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Rok vydání: | 2012 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Surgical margin Time Factors medicine.medical_treatment Urology Kaplan-Meier Estimate Multimodal Imaging Article Young Adult Fluorodeoxyglucose F18 Antineoplastic Combined Chemotherapy Protocols Outcome Assessment Health Care medicine Humans Prospective Studies Survival analysis Neoadjuvant therapy Aged Aged 80 and over business.industry Soft tissue sarcoma Cancer Sarcoma Middle Aged medicine.disease Prognosis Confidence interval Neoadjuvant Therapy Oncology Positron-Emission Tomography Multivariate Analysis Biomarker (medicine) Histopathology Female Radiopharmaceuticals Nuclear medicine business Tomography X-Ray Computed Follow-Up Studies |
Zdroj: | Clinical cancer research : an official journal of the American Association for Cancer Research. 18(7) |
ISSN: | 1557-3265 |
Popis: | Purpose: Neoadjuvant therapy is associated with considerable toxicity and limited survival benefits in patients with soft tissue sarcoma (STS). We prospectively evaluated whether 2[18F]fluoro-2-deoxy-d-glucose (18F-FDG)-PET/computed tomographic (CT) imaging after the initial cycle of neoadjuvant therapy could predict overall survival in these patients. Experimental Design: Thirty-nine patients underwent 18F-FDG-PET/CT before and after one cycle of neoadjuvant therapy. Fifty-six patients underwent end-of-treatment PET. Overall survival was, among others, correlated with changes of SUVpeak and histopathology. Results: One-, two-, and five-year survival rates were 95% ± 3.0%, 86% ± 4.6%, and 68% ± 6.6%, respectively. Median time to death was 30.9 months (mean, 27.7; range, 6.9–50.1). Optimal cutoff values for early and late decreases in SUVpeak (26% and 57%, respectively) were significant predictors of survival in univariate survival analysis [P = 0.041; HR, 0.27; 95% confidence interval (CI), 0.08–0.95 and P = 0.045; HR, 0.31; 95% CI, 0.10–0.98]. Seven of 15 early PET nonresponders but only four of 24 early PET responders died during follow-up (P = 0.068). The only other significant survival predictor was surgical margin positivity (P = 0.041; HR, 3.31; 95% CI, 1.05–10.42). By multivariable analysis, early metabolic response (P = 0.016) and positivity of surgical margins (P = 0.036) remained significant survival predictors. Conclusion: 18F-FDG-PET predicted survival after the initial cycle of neoadjuvant chemotherapy in patients with STS and can potentially serve as an intermediate endpoint biomarker in clinical research and patient care. Clin Cancer Res; 18(7); 2024–31. ©2012 AACR. |
Databáze: | OpenAIRE |
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