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Prediction of patient outcome with 2-deoxy-2-[18F]fluoro-D-glucose-positron emission tomography early during radiotherapy for locally advanced cervical cancer.

Bjurberg, Maria LU ; Kjellén, Elisabeth LU ; Ohlsson, Tomas G LU ; Bendahl, Pär-Ola LU and Brun, Eva LU (2009) In International Journal of Gynecological Cancer 19(9). p.1600-1605
Abstract
INTRODUCTION: It is difficult to assess the individual response of locally advanced cervical cancer to chemoradiation therapy during the course of treatment. We have investigated the predictive value of positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) early during treatment in relation to progression-free survival. METHODS: This prospective single-center clinical trial included women with locally advanced cervical cancer from 2004 to 2008. 2-Deoxy-2-[18F]fluoro-D-glucose-PET/computed tomography was performed at baseline, during the third week of treatment and, finally, 3 months after the completion of treatment. The images were evaluated visually, semiquantitatively with the maximum standardized uptake value,... (More)
INTRODUCTION: It is difficult to assess the individual response of locally advanced cervical cancer to chemoradiation therapy during the course of treatment. We have investigated the predictive value of positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) early during treatment in relation to progression-free survival. METHODS: This prospective single-center clinical trial included women with locally advanced cervical cancer from 2004 to 2008. 2-Deoxy-2-[18F]fluoro-D-glucose-PET/computed tomography was performed at baseline, during the third week of treatment and, finally, 3 months after the completion of treatment. The images were evaluated visually, semiquantitatively with the maximum standardized uptake value, and by calculating the metabolic rate of FDG. Thirty-two patients were eligible for full evaluation. RESULTS: The median follow-up time was 28 months (range, 5-53 months). Visual metabolic complete response on FDG-PET, after a mean irradiation dose of 23 Gy (range, 16-27 Gy), was found in 7 patients, none of which relapsed. Eleven of the 25 patients with remaining malignant hypermetabolism on the second FDG-PET relapsed. Neither maximum standardized uptake value nor metabolic rate of FDG could further discriminate between patients with low risk and patients with high risk of relapse. The follow-up FDG-PET performed 3 months after the completion of treatment identified a group of patients with poor prognosis. CONCLUSIONS: In conclusion, FDG-PET early during chemoradiation therapy identified a small number of patients with an excellent prognosis. However, FDG-PET at this early point in time during treatment failed to predict the outcome for most patients. Future clinical trials to determine the optimal timing of predictive FDG-PET are thus warranted. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Gynecological Cancer
volume
19
issue
9
pages
1600 - 1605
publisher
Wiley-Blackwell
external identifiers
  • wos:000272898400027
  • pmid:19955945
  • scopus:77649196723
ISSN
1048-891X
DOI
10.1111/IGC.0b013e3181c00359
language
English
LU publication?
yes
id
b9b3d7e0-2030-4995-8db5-7d7741c563c4 (old id 1524082)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19955945?dopt=Abstract
date added to LUP
2010-01-08 14:17:51
date last changed
2017-05-28 03:38:40
@article{b9b3d7e0-2030-4995-8db5-7d7741c563c4,
  abstract     = {INTRODUCTION: It is difficult to assess the individual response of locally advanced cervical cancer to chemoradiation therapy during the course of treatment. We have investigated the predictive value of positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) early during treatment in relation to progression-free survival. METHODS: This prospective single-center clinical trial included women with locally advanced cervical cancer from 2004 to 2008. 2-Deoxy-2-[18F]fluoro-D-glucose-PET/computed tomography was performed at baseline, during the third week of treatment and, finally, 3 months after the completion of treatment. The images were evaluated visually, semiquantitatively with the maximum standardized uptake value, and by calculating the metabolic rate of FDG. Thirty-two patients were eligible for full evaluation. RESULTS: The median follow-up time was 28 months (range, 5-53 months). Visual metabolic complete response on FDG-PET, after a mean irradiation dose of 23 Gy (range, 16-27 Gy), was found in 7 patients, none of which relapsed. Eleven of the 25 patients with remaining malignant hypermetabolism on the second FDG-PET relapsed. Neither maximum standardized uptake value nor metabolic rate of FDG could further discriminate between patients with low risk and patients with high risk of relapse. The follow-up FDG-PET performed 3 months after the completion of treatment identified a group of patients with poor prognosis. CONCLUSIONS: In conclusion, FDG-PET early during chemoradiation therapy identified a small number of patients with an excellent prognosis. However, FDG-PET at this early point in time during treatment failed to predict the outcome for most patients. Future clinical trials to determine the optimal timing of predictive FDG-PET are thus warranted.},
  author       = {Bjurberg, Maria and Kjellén, Elisabeth and Ohlsson, Tomas G and Bendahl, Pär-Ola and Brun, Eva},
  issn         = {1048-891X},
  language     = {eng},
  number       = {9},
  pages        = {1600--1605},
  publisher    = {Wiley-Blackwell},
  series       = {International Journal of Gynecological Cancer},
  title        = {Prediction of patient outcome with 2-deoxy-2-[18F]fluoro-D-glucose-positron emission tomography early during radiotherapy for locally advanced cervical cancer.},
  url          = {http://dx.doi.org/10.1111/IGC.0b013e3181c00359},
  volume       = {19},
  year         = {2009},
}