The early prediction of pathological response to neoadjuvant chemotherapy and prognosis

Autor: Shaoli Song, Weiling Lian, Bingxin Gu, Yingjian Zhang, Zhongyi Yang, Ming-Wei Wang, Linjun Lu, Herong Pan, Cheng Liu, Zhifeng Yao, Jianping Zhang
Rok vydání: 2020
Předmět:
Adult
Oncology
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
Breast Neoplasms
Standardized uptake value
Kaplan-Meier Estimate
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Breast cancer
Fluorodeoxyglucose F18
Predictive Value of Tests
Positron Emission Tomography Computed Tomography
Internal medicine
Humans
Medicine
Radiology
Nuclear Medicine and imaging
Progression-free survival
Response Evaluation Criteria in Solid Tumors
Aged
Chemotherapy
business.industry
Cancer
General Medicine
Middle Aged
Prognosis
medicine.disease
Neoadjuvant Therapy
Progression-Free Survival
Early Diagnosis
030220 oncology & carcinogenesis
Predictive value of tests
Female
Neoplasm Recurrence
Local
Radiopharmaceuticals
business
Glycolysis
Zdroj: Nuclear Medicine Communications. 41:280-287
ISSN: 0143-3636
DOI: 10.1097/mnm.0000000000001145
Popis: Objective To compare the predictive value of European Organization for Research and Treatment of Cancer (EORTC) criteria and PET Response Criteria in Solid Tumors (PERCIST), for the pathological response and prognosis of patients with breast cancer receiving neoadjuvant chemotherapy (NAC). Methods Consecutive PET/computed tomography scans in 128 operable female patients at baseline and after two courses of NAC were performed. Patients were categorized by complete metabolic response (CMR) and non-CMR groups using 2 PET criteria. CMR and non-CMR were used to predict pathological complete response (pCR) by diagnostic test evaluation, and to predict progression-free survival (PFS) using Kaplan-Meier plots and Cox proportional hazards regression. Results Ninety-two patients were finally analyzed. The sensitivity, specificity, and accuracy for pCR prediction were 69.7, 76.3, and 73.9% with EORTC criteria, and 69.7, 77.9, and 75.0% with PERCIST, respectively. Peak standardized uptake value normalized to lean body mass (SULpeak), maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were pCR response with accuracy of 70.7, 60.0, 75.0, and 71.4%, respectively. CMR by the EORTC (P = 0.021) and PERCIST (P = 0.007) was significantly related to a longer PFS. The univariate and multivariate analysis suggested that CMR by PERCIST was an independent predictor of recurrence (P = 0.008). Conclusion EORTC criteria and PERCIST had early predictive value to long-term outcome, but moderate value for pCR. Furthermore, PERCIST might show more potential than the EORTC criteria and conventional PET-based parameters to predict prognosis in breast cancer patients following two cycles of neoadjuvant chemotherapy.Video abstract: see http://links.lww.com/NMC/A162.
Databáze: OpenAIRE
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