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- Title
Early Assessment of Response to Neoadjuvant Chemotherapy with <sup>18</sup>F-FDG-PET/CT in Patients with Advanced-Stage Ovarian Cancer.
- Authors
Young Shin Chung; Hyun-Soo Kim; Jung-Yun Lee; Won Jun Kang; Eun Ji Nam; Sunghoon Kim; Sang Wun Kim; Young Tae Kim
- Abstract
Purpose The aim of this study was to evaluate the ability of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) after one cycle of neoadjuvant chemotherapy (NAC) to predict chemotherapy response before interval debulking surgery (IDS) in advanced-stage ovarian cancer patients. Materials and Methods Forty consecutive patients underwent 18F-FDG-PET/CT at baseline and after one cycle of NAC. Metabolic responses were assessed by quantitative decrease in the maximum standardized uptake value (SUVmax) with PET/CT. Decreases in SUVmax were compared with cancer antigen 125 (CA-125) level before IDS, response rate by Response Evaluation Criteria in Solid Tumors criteria before IDS, residual tumor at IDS, and I chemotherapy response score (CRS) at IDS. Results A 40% cut-off for the decrease in SUVmax provided the best performance to predict CRS 3 (compete or near-complete pathologic response), with sensitivity, specificity, and accuracy of 81.8%, 72.4%, and 72.4%, respectively. According to this 40% cut-off, there were 17 (42.5%) metabolic responders (≥ 40%) and 23 (57.5%) metabolic non-responders (< 40%). Metabolic responders had higher rate of CRS 3 (52.9% vs. 8.7%, p=0.003), CA-125 normalization (< 35 U/mL) before IDS (76.5% vs. 39.1%, p=0.019), and no residual tumor at IDS (70.6% vs. 31.8%, p=0.025) compared with metabolic non-responders. There were significant associations with progression-free survival (p=0.021) between metabolic responders and non-responders, but not overall survival (p=0.335). Conclusion Early assessment with 18F-FDG-PET/CT after one cycle of NAC can be useful to predic response to chemotherapy before IDS in patients with advanced-stage ovarian cancer.
- Subjects
NEOADJUVANT chemotherapy; OVARIAN cancer; POSITRON emission tomography computed tomography; PROGRESSION-free survival; TREATMENT effectiveness
- Publication
Cancer Research & Treatment, 2020, Vol 52, Issue 4, p1211
- ISSN
1598-2998
- Publication type
Article
- DOI
10.4143/crt.2019.506