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- Title
Prognostic value of posttreatment <sup>18</sup>F-FDG PET/CT and predictors of metabolic response to therapy in patients with locally advanced cervical cancer treated with concomitant chemoradiation therapy: an analysis of intensity- and volume-based PET parameters.
- Authors
Lima, Giacomo Maria; Matti, Antonella; Vara, Giulio; Dondi, Giulia; Naselli, Nicoletta; De Crescenzo, Eugenia Maria; Morganti, Alessio Giuseppe; Perrone, Anna Myriam; De Iaco, Pierandrea; Nanni, Cristina; Fanti, Stefano
- Abstract
Purpose: To investigate the prognostic value of posttreatment 18F-FDG PET/CT in patients with locally advanced cervical cancer (LACC) treated with concomitant chemoradiation therapy (CCRT). The secondary aim was to assess the possible role of intensity-based and volume-based PET parameters including SUVmax, SUVmean, MTV and TLG, and clinical parameters including age, pathology, FIGO stage and nodal involvement as factors predicting response to treatment.Methods: This retrospective study included 82 patients affected by LACC treated with CCRT. All patients underwent 18F-FDG PET/CT both before and after treatment. The posttreatment PET/CT scans were used to classify patients as complete metabolic responders (CMR) or non-complete metabolic responders (N-CMR) according to the EORTC criteria. Kaplan-Meier analysis was used to evaluate differences in overall survival (OS) between the CMR and N-CMR groups. Student’s t test, Pearson’s chi-squared test and logistic regression were used to investigate the possible value of PET and clinical parameters as predictors of metabolic response to therapy.Results: KaplanMeier analysis showed a highly significant difference in OS between the CMR and N-CMR groups (log-rank test p < 0.0001). Significant independent predictors of response to therapy were MTV (p = 0.019, odds ratio = 1.015, 95% CI = 1.002-1.028, Nagelkerke R2 = 0.110), TLG (p = 0.045, odds ratio = 1.001, 95% CI = 1.000-1.002, Nagelkerke R2 = 0.081) and nodal involvement (p = 0.088, odds ratio = 2.361, 95% CI = 0.879-6.343, Nagelkerke R2 = 0.051).Conclusion: 18F-FDG PET/CT-based response assessment using the EORTC criteria reliably predicts OS in LACC patients treated with CCRT. In our cohort of patients, pretreatment MTV and TLG and nodal involvement were predictors of response to therapy. MTV was the best predictor of response. However, its additional risk value seems to be low (MTV odds ratio = 1.015).
- Subjects
CERVICAL cancer patients; CERVICAL cancer treatment; POSITRON emission tomography; COMPUTED tomography; METABOLIC disorder diagnosis
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2018, Vol 45, Issue 12, p2139
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-018-4077-1