Abstract
PurposeTo investigate the prognostic value of posttreatment 18F-FDG PET/CT in patients with locally advanced cervical cancer (LACC) treated with concomitant chemoradiation therapy (CCRT). The secondary aim was to assess the possible role of intensity-based and volume-based PET parameters including SUVmax, SUVmean, MTV and TLG, and clinical parameters including age, pathology, FIGO stage and nodal involvement as factors predicting response to treatment.MethodsThis retrospective study included 82 patients affected by LACC treated with CCRT. All patients underwent 18F-FDG PET/CT both before and after treatment. The posttreatment PET/CT scans were used to classify patients as complete metabolic responders (CMR) or non-complete metabolic responders (N-CMR) according to the EORTC criteria. Kaplan-Meier analysis was used to evaluate differences in overall survival (OS) between the CMR and N-CMR groups. Student’s t test, Pearson’s chi-squared test and logistic regression were used to investigate the possible value of PET and clinical parameters as predictors of metabolic response to therapy.ResultsKaplanMeier analysis showed a highly significant difference in OS between the CMR and N-CMR groups (log-rank test p < 0.0001). Significant independent predictors of response to therapy were MTV (p = 0.019, odds ratio = 1.015, 95% CI = 1.002–1.028, Nagelkerke R2 = 0.110), TLG (p = 0.045, odds ratio = 1.001, 95% CI = 1.000–1.002, Nagelkerke R2 = 0.081) and nodal involvement (p = 0.088, odds ratio = 2.361, 95% CI = 0.879–6.343, Nagelkerke R2 = 0.051).Conclusion18F-FDG PET/CT-based response assessment using the EORTC criteria reliably predicts OS in LACC patients treated with CCRT. In our cohort of patients, pretreatment MTV and TLG and nodal involvement were predictors of response to therapy. MTV was the best predictor of response. However, its additional risk value seems to be low (MTV odds ratio = 1.015).
Highlights
BackgroundCervical cancer is the fourth most common cancer in women with an estimated 528,000 new cases reported in 2012
We investigated whether SUVmax, SUVmean, metabolic tumour volume (MTV) and total lesion glycolysis (TLG), age, pathology findings, Federation of Gynecology and Obstetrics (FIGO) stage and nodal involvement could predict the metabolic response to therapy
Even though clinical response is routinely assessed in locally advanced cervical cancer (LACC) patients, in our study, the PET/CT scan led to reclassification of 24 of the 82 patients (29.3%)
Summary
BackgroundCervical cancer is the fourth most common cancer in women with an estimated 528,000 new cases reported in 2012. A major part (around 85% of cases) of the global burden occurs in developing countries [1, 2]. This is due to a lack of screening that is the most important public health intervention to reduce both the incidence and mortality of the disease [3,4,5,6]. Eur J Nucl Med Mol Imaging (2018) 45:2139–2146 cervical cancer (up to FIGO stage IIa) without risk factors. Otherwise the standard of care for locally advanced cervical cancer (LACC; FIGO Ib2–IVa) is concomitant chemoradiation therapy (CCRT) [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: European Journal of Nuclear Medicine and Molecular Imaging
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
