In:
Cancer Research and Treatment, Korean Cancer Association, Vol. 53, No. 3 ( 2021-07-15), p. 803-812
Abstract:
Purpose This study aimed to identify the prognostic value of early metabolic response assessed using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) during radiation therapy (RT) for cervical cancer.Materials and Methods We identified 116 patients treated with definitive RT, including FDG-PET/CT–guided intracavitary brachytherapy, between 2009 and 2018. We calculated parameters including maximum (SUV 〈 sub 〉 max 〈 /sub 〉 ) and mean standardized uptake values (SUV 〈 sub 〉 mean 〈 /sub 〉 ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for baseline FDG-PET/CT (PET 〈 sub 〉 base 〈 /sub 〉 ) and image-guided brachytherapy planning FDG-PET/CT (PET 〈 sub 〉 IGBT 〈 /sub 〉 ). Multivariable analyses of disease-free survival (DFS) and overall survival (OS) were performed.Results We observed a time-dependent decrease in PET parameters between PET 〈 sub 〉 base 〈 /sub 〉 and PET 〈 sub 〉 IGBT 〈 /sub 〉 ; ΔSUV 〈 sub 〉 max 〈 /sub 〉 , ΔSUV 〈 sub 〉 mean 〈 /sub 〉 , ΔMTV, and ΔTLG were 65%, 61%, 78%, and 93%, respectively. With a median follow-up of 59.5 months, the 5-year DFS and OS rates were 66% and 79%, respectively. Multivariable analysis demonstrated that ΔSUV 〈 sub 〉 max 〈 /sub 〉 ≥ 50% was associated with favorable DFS (hazard ratio [HR], 2.56; 95% confidence interval [CI] , 1.14 to 5.77) and OS (HR, 5.14; 95% CI, 1.55 to 17.01). Patients with ΔSUV 〈 sub 〉 max 〈 /sub 〉 ≥ 50% (n=87) showed better DFS and OS than those with ΔSUV 〈 sub 〉 max 〈 /sub 〉 〈 50% (n=29) (DFS, 76% vs. 35%, p 〈 0.001; OS, 90% vs. 41%, p 〈 0.001, respectively). Adenocarcinoma was frequently observed in ΔSUV 〈 sub 〉 max 〈 /sub 〉 〈 50% compared to ΔSUV 〈 sub 〉 max 〈 /sub 〉 ≥ 50% (27.6% vs. 10.3%, p=0.003). In addition, models incorporating metabolic parameters showed improved accuracy for predicting DFS (p=0.012) and OS (p=0.004) than models with clinicopathologic factors.Conclusion Changes in metabolic parameters, especially those in SUV 〈 sub 〉 max 〈 /sub 〉 by 〉 50%, can help improve survival outcome predictions for patients with cervical cancer treated with definitive RT.
Type of Medium:
Online Resource
ISSN:
1598-2998
,
2005-9256
DOI:
10.4143/crt.2020.1251
Language:
English
Publisher:
Korean Cancer Association
Publication Date:
2021
detail.hit.zdb_id:
2514151-X
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