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The prognostic value of FET PET at radiotherapy planning in newly diagnosed glioblastoma

Poulsen, Sidsel Højklint ; Urup, Thomas ; Grunnet, Kirsten ; Christensen, Ib Jarle ; Larsen, Vibeke Andrée ; Jensen, Michael Lundemann ; af Rosenschöld, Per Munck LU orcid ; Poulsen, Hans Skovgaard and Law, Ian (2017) In European Journal of Nuclear Medicine and Molecular Imaging 44(3). p.373-381
Abstract

Background: Glioblastoma patients show a great variability in progression free survival (PFS) and overall survival (OS). To gain additional pretherapeutic information, we explored the potential of O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET as an independent prognostic biomarker. Methods: We retrospectively analyzed 146 consecutively treated, newly diagnosed glioblastoma patients. All patients were treated with temozolomide and radiation therapy (RT). CT/MR and FET PET scans were obtained postoperatively for RT planning. We used Cox proportional hazards models with OS and PFS as endpoints, to test the prognostic value of FET PET biological tumor volume (BTV). Results: Median follow-up time was 14 months, and median OS and PFS... (More)

Background: Glioblastoma patients show a great variability in progression free survival (PFS) and overall survival (OS). To gain additional pretherapeutic information, we explored the potential of O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET as an independent prognostic biomarker. Methods: We retrospectively analyzed 146 consecutively treated, newly diagnosed glioblastoma patients. All patients were treated with temozolomide and radiation therapy (RT). CT/MR and FET PET scans were obtained postoperatively for RT planning. We used Cox proportional hazards models with OS and PFS as endpoints, to test the prognostic value of FET PET biological tumor volume (BTV). Results: Median follow-up time was 14 months, and median OS and PFS were 16.5 and 6.5 months, respectively. In the multivariate analysis, increasing BTV (HR = 1.17, P < 0.001), poor performance status (HR = 2.35, P < 0.001), O(6)-methylguanine-DNA methyltransferase protein status (HR = 1.61, P = 0.024) and higher age (HR = 1.32, P = 0.013) were independent prognostic factors of poor OS. For poor PFS, only increasing BTV (HR = 1.18; P = 0.002) was prognostic. A prognostic index for OS was created based on the identified prognostic factors. Conclusion: Large BTV on FET PET is an independent prognostic factor of poor OS and PFS in glioblastoma patients. With the introduction of FET PET, we obtain a prognostic index that can help in glioblastoma treatment planning.

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author
; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomarker, FET PET, Glioblastoma, Prognostic index, Radiation therapy
in
European Journal of Nuclear Medicine and Molecular Imaging
volume
44
issue
3
pages
373 - 381
publisher
Springer
external identifiers
  • pmid:27554774
  • scopus:84983442155
ISSN
1619-7070
DOI
10.1007/s00259-016-3494-2
language
English
LU publication?
no
additional info
Publisher Copyright: © 2016, The Author(s).
id
fc874933-8060-4a19-a84b-3eee133bdd73
date added to LUP
2023-07-19 17:09:44
date last changed
2024-04-19 23:45:59
@article{fc874933-8060-4a19-a84b-3eee133bdd73,
  abstract     = {{<p>Background: Glioblastoma patients show a great variability in progression free survival (PFS) and overall survival (OS). To gain additional pretherapeutic information, we explored the potential of O-(2-<sup>18</sup>F-fluoroethyl)-L-tyrosine (FET) PET as an independent prognostic biomarker. Methods: We retrospectively analyzed 146 consecutively treated, newly diagnosed glioblastoma patients. All patients were treated with temozolomide and radiation therapy (RT). CT/MR and FET PET scans were obtained postoperatively for RT planning. We used Cox proportional hazards models with OS and PFS as endpoints, to test the prognostic value of FET PET biological tumor volume (BTV). Results: Median follow-up time was 14 months, and median OS and PFS were 16.5 and 6.5 months, respectively. In the multivariate analysis, increasing BTV (HR = 1.17, P &lt; 0.001), poor performance status (HR = 2.35, P &lt; 0.001), O(6)-methylguanine-DNA methyltransferase protein status (HR = 1.61, P = 0.024) and higher age (HR = 1.32, P = 0.013) were independent prognostic factors of poor OS. For poor PFS, only increasing BTV (HR = 1.18; P = 0.002) was prognostic. A prognostic index for OS was created based on the identified prognostic factors. Conclusion: Large BTV on FET PET is an independent prognostic factor of poor OS and PFS in glioblastoma patients. With the introduction of FET PET, we obtain a prognostic index that can help in glioblastoma treatment planning.</p>}},
  author       = {{Poulsen, Sidsel Højklint and Urup, Thomas and Grunnet, Kirsten and Christensen, Ib Jarle and Larsen, Vibeke Andrée and Jensen, Michael Lundemann and af Rosenschöld, Per Munck and Poulsen, Hans Skovgaard and Law, Ian}},
  issn         = {{1619-7070}},
  keywords     = {{Biomarker; FET PET; Glioblastoma; Prognostic index; Radiation therapy}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{3}},
  pages        = {{373--381}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nuclear Medicine and Molecular Imaging}},
  title        = {{The prognostic value of FET PET at radiotherapy planning in newly diagnosed glioblastoma}},
  url          = {{http://dx.doi.org/10.1007/s00259-016-3494-2}},
  doi          = {{10.1007/s00259-016-3494-2}},
  volume       = {{44}},
  year         = {{2017}},
}