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
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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