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FDG-PET in Cervical Cancer - Translational Studies

Bjurberg, Maria LU (2010) In Lund University Faculty of Medicine Doctoral Dissertation Series 2010:50.
Abstract (Swedish)
Popular Abstract in Swedish

Livmoderhalscancer är den näst vanligaste cancerformen att drabba kvinnor. Behandlingen baseras på vilket stadium sjukdomen befinner sig i och innebär en avsevärd risk för biverkningar. FDG-PET är en undersökningsmetod som kan visualisera områden i kroppen med ökat sockerupptag. Cancerceller har en kraftigt ökad omsättning av socker och därmed kan tumörer avbildas med FDG-PET.



Målet med denna avhandling var att utvärdera nyttan av FDG-PET i handläggningen av patienter med livmoderhalscancer samt att experimentellt undersöka de förändringar i sockeromsättning som uppstår i en tumör efter behandling med cytostatika.



I patientstudien fann vi att FDG-PET gav... (More)
Popular Abstract in Swedish

Livmoderhalscancer är den näst vanligaste cancerformen att drabba kvinnor. Behandlingen baseras på vilket stadium sjukdomen befinner sig i och innebär en avsevärd risk för biverkningar. FDG-PET är en undersökningsmetod som kan visualisera områden i kroppen med ökat sockerupptag. Cancerceller har en kraftigt ökad omsättning av socker och därmed kan tumörer avbildas med FDG-PET.



Målet med denna avhandling var att utvärdera nyttan av FDG-PET i handläggningen av patienter med livmoderhalscancer samt att experimentellt undersöka de förändringar i sockeromsättning som uppstår i en tumör efter behandling med cytostatika.



I patientstudien fann vi att FDG-PET gav ytterligare information om tumörspridning jämfört med de undersökningsmetoder som annars används samt att denna information ledde till förändringar i behandlingsplanerna för en fjärdedel av patienterna med lokalt avancerad sjukdom eller återfall. däremot såg man ingen nytta med FDG-PET hos symptomfria patienter 6 månader efter operation för tidig livmoderhalscancer. Med FDG-PET tidigt under pågående strålbehandling var det möjligt att identifiera en liten grupp patienter med mycket god prognos. Kvarstående ökat sockerupptag i tumören 3 månader efter avslutad strålbehandling innedar en dålig prognos.



Expermimentellt fann vi en tidig och snabbt övergående ökning av sockerupptaget i tumörer 1 dygn efter cytostatikabehandling. Denna tillfälliga ökning av sockerupptag var tydligast hos de tumörceller som svarade på behandlingen. Bakomliggande mekanism till detta fenomen är okänd.



Sammanfattningsvis har vi påvisat en patientnytta med FDG-PET för vissa grupper av patienter med livmoderhalscancer och experimentellt har vi utökat kunskaperna om cancercellers sockeromsättning. (Less)
Abstract
Cervical cancer is the second most common cancer in females. The treatment, based on clinical FIGO stage, carries a significant risk of side effects. FDG-PET enables non-invasive studies of glucose metabolism. Cancer cells show an increased glucose uptake and metabolism that can be visualised and further analysed.



The aims of this thesis were to evaluate FDG-PET in the clinical management of cervical cancer and to experimentally investigate the metabolic changes in a tumour following cytotoxic treatment.



In a prospective study we found that FDG-PET provided important information about the extent of the disease in primary staging of locally advanced cases and in re-staging of recurrent disease. The... (More)
Cervical cancer is the second most common cancer in females. The treatment, based on clinical FIGO stage, carries a significant risk of side effects. FDG-PET enables non-invasive studies of glucose metabolism. Cancer cells show an increased glucose uptake and metabolism that can be visualised and further analysed.



The aims of this thesis were to evaluate FDG-PET in the clinical management of cervical cancer and to experimentally investigate the metabolic changes in a tumour following cytotoxic treatment.



In a prospective study we found that FDG-PET provided important information about the extent of the disease in primary staging of locally advanced cases and in re-staging of recurrent disease. The treatment plans were altered as a result of the FDG-PET findings for one fourth of the patients. Surveillance FDG-PET 6 months after surgery for early-stage disease showed no clinical value. With a predictive FDG-PET early during radiotherapy for locally advanced disease we could identify a group of patients with an excellent prognosis. However, for the majority of the patients early prediction of outcome was not possible. Persisting hypermetabolism on FDG-PET 3 months after completed radiotherapy was associated with relapse.



Experimentally, we found a transient metabolic flare in xenografted tumours on day 1 following cisplatin exposure. A metabolic flare in squamous cell carcinoma cells in vitro was found to be an early sign of response to cisplatin treatment. No increase in metabolism was detected in fibroblasts in vitro or in reactive cells in vivo.



In conclusion, we have demonstrated a clinical value of FDG-PET in the management of cervical cancer, and in an experimental setting we have increased the understanding of tumour metabolism. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Grénman, Seija, Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland
organization
publishing date
type
Thesis
publication status
published
subject
in
Lund University Faculty of Medicine Doctoral Dissertation Series
volume
2010:50
pages
80 pages
publisher
Department of Oncology, Clinical Sciences, Lund University
defense location
Segerfalksalen, BMC hus A, Sölvegatan 19, Lund
defense date
2010-05-21 13:00
ISSN
1652-8220
ISBN
978-91-86443-65-8
language
English
LU publication?
yes
id
a9f3c13c-5dfc-4df7-a11b-f4b1e0a19b73 (old id 1580925)
date added to LUP
2010-03-31 08:14:24
date last changed
2018-05-29 10:50:12
@phdthesis{a9f3c13c-5dfc-4df7-a11b-f4b1e0a19b73,
  abstract     = {Cervical cancer is the second most common cancer in females. The treatment, based on clinical FIGO stage, carries a significant risk of side effects. FDG-PET enables non-invasive studies of glucose metabolism. Cancer cells show an increased glucose uptake and metabolism that can be visualised and further analysed.<br/><br>
<br/><br>
The aims of this thesis were to evaluate FDG-PET in the clinical management of cervical cancer and to experimentally investigate the metabolic changes in a tumour following cytotoxic treatment. <br/><br>
<br/><br>
In a prospective study we found that FDG-PET provided important information about the extent of the disease in primary staging of locally advanced cases and in re-staging of recurrent disease. The treatment plans were altered as a result of the FDG-PET findings for one fourth of the patients. Surveillance FDG-PET 6 months after surgery for early-stage disease showed no clinical value. With a predictive FDG-PET early during radiotherapy for locally advanced disease we could identify a group of patients with an excellent prognosis. However, for the majority of the patients early prediction of outcome was not possible. Persisting hypermetabolism on FDG-PET 3 months after completed radiotherapy was associated with relapse. <br/><br>
<br/><br>
Experimentally, we found a transient metabolic flare in xenografted tumours on day 1 following cisplatin exposure. A metabolic flare in squamous cell carcinoma cells in vitro was found to be an early sign of response to cisplatin treatment. No increase in metabolism was detected in fibroblasts in vitro or in reactive cells in vivo.<br/><br>
<br/><br>
In conclusion, we have demonstrated a clinical value of FDG-PET in the management of cervical cancer, and in an experimental setting we have increased the understanding of tumour metabolism.},
  author       = {Bjurberg, Maria},
  isbn         = {978-91-86443-65-8},
  issn         = {1652-8220},
  language     = {eng},
  pages        = {80},
  publisher    = {Department of Oncology, Clinical Sciences, Lund University},
  school       = {Lund University},
  series       = {Lund University Faculty of Medicine Doctoral Dissertation Series},
  title        = {FDG-PET in Cervical Cancer - Translational Studies},
  volume       = {2010:50},
  year         = {2010},
}