Prognostic Significance of Tumor Response as Assessed by Sequential 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography During Concurrent Chemoradiation Therapy for Cervical Cancer
Autor: | Jeong-Eun Lee, Dongryul Oh, Joon Young Choi, Seung Jae Huh, Won Soon Park, Byung-Tae Kim, Heerim Nam |
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Rok vydání: | 2013 |
Předmět: |
Adult
Cancer Research medicine.medical_specialty Brachytherapy Uterine Cervical Neoplasms Antineoplastic Agents Standardized uptake value Computed tomography Adenocarcinoma Multimodal Imaging Disease-Free Survival Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging Aged Aged 80 and over Cervical cancer Fluorodeoxyglucose Radiation Receiver operating characteristic medicine.diagnostic_test business.industry Chemoradiotherapy Concurrent chemoradiation Middle Aged Prognosis medicine.disease Survival Rate Treatment Outcome ROC Curve Oncology Positron emission tomography Positron-Emission Tomography Carcinoma Squamous Cell Female Fluorouracil Radiology Cisplatin Radiopharmaceuticals Radiotherapy Conformal Tomography X-Ray Computed business Nuclear medicine Progressive disease medicine.drug |
Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 87:549-554 |
ISSN: | 0360-3016 |
Popis: | To investigate the prognostic role of metabolic response by the use of serial sets of positron emission tomography/computed tomography (PET/CT) in patients with cervical cancer who were treated with concurrent chemoradiation therapy (CCRT).A total of 60 patients who were treated with CCRT between February 2009 and December 2010 were analyzed. Three sequential PET/CT images were acquired for each patient: pre-CCRT, during-CCRT at 4 weeks of CCRT, and 1 month post-CCRT PET/CT. Metabolic responses were assessed qualitatively. The percentage changes in the maximum values of standardized uptake value (ΔSUV(max)%) from the PET/CT images acquired pre-CCRT and during-CCRT were calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate whether ΔSUV(max)% could predict complete response (CR) on the post-CCRT PET/CT and to identify the best cutoff value. Prognostic factors of progression-free survival (PFS) were analyzed.During-CCRT PET/CT showed that 8 patients (13%) had CR, and the other 52 patients (87%) had partial response (PR). On the post-CCRT PET/CT, 43 patients (73%) had CR, 12 patients (20%) had PR, and 4 patients (7%) had progressive disease. The average SUV(max) in primary tumors was 16.3 (range, 6.4-53.0) on the pre-CCRT PET/CT images and 5.3 (range, 0-19.4) on the during-CCRT PET/CT images. According to ROC curve analysis, ΔSUV(max)% could predict CR response on post-CCRT PET/CT (P.001, cutoff value of 59.7%). In all patients, the PFS rate was 71.9% at 2 years. Multivariate analysis showed that ΔSUV(max)% ≥60% (P=.045) and CR response on the post-CCRT PET/CT (P=.012) were statistically significant predictors of PFS.Metabolic responses on the during-CCRT images at 4 weeks of treatment and 1-month post-CCRT PET/CT images may predict treatment outcomes in patients with cervical cancer. ΔSUV(max)% ≥60% at 4 weeks of CCRT may predict CR response on 1-month post-CCRT PET/CT and also PFS. |
Databáze: | OpenAIRE |
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