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F-18-FDG-PET/CT based total metabolic tumor volume change during neoadjuvant chemotherapy predicts outcome in advanced epithelial ovarian cancer




TekijätVallius T, Hynninen J, Kemppainen J, Alves V, Auranen K, Matomäki J, Oksa S, Virtanen J, Grénman S, Auranen A, Seppänen M

KustantajaSPRINGER

Julkaisuvuosi2018

JournalEuropean Journal of Nuclear Medicine and Molecular Imaging

Tietokannassa oleva lehden nimiEUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Lehden akronyymiEUR J NUCL MED MOL I

Vuosikerta45

Numero7

Aloitussivu1224

Lopetussivu1232

Sivujen määrä9

ISSN1619-7070

eISSN1619-7089

DOIhttps://doi.org/10.1007/s00259-018-3961-z


Tiivistelmä

Objective: To evaluate the predictive potential of total metabolic tumor volume (MTV) reduction during neoadjuvant chemotherapy (NACT) with F-18 FDG-PET/CT in an advanced FIGO stage III/IV epithelial ovarian cancer (EOC) patient cohort.

Methods: Twenty-nine primarily inoperable EOC patients underwent F-18 FDG-PET/CT before and after NACT. The pre- and post-NACT total MTV, in addition to the percentage MTV reduction during NACT, were compared with primary therapy outcome and progression-free survival (PFS). ROC-analysis determined an optimal threshold for MTV reduction identifying patients with progressive or stable disease (PD/SD) at the end of primary therapy. A multivariate analysis with residual tumor (0/>0), FIGO stage (III/IV) and MTV reduction compared to PFS was performed. The association between MTV reduction and overall survival (OS) was evaluated.

Results: The median pre- and post-NACT total MTV were 352 cm(3) (range 150 to 1322 cm(3)) and 51 cm(3) (range 0 to 417 cm(3)), respectively. The median MTV reduction during NACT was 89% (range 24% to 100%). Post-NACT MTV and MTV reduction associated with primary therapy outcome (MTV post-NACT p = 0.007, MTV reduction p = 0.001) and PFS (MTV post-NACT p = 0.005, MTV reduction p = 0.005). MTV reduction <85% identified the PD/SD patients (sensitivity 70%, specificity 78%, AUC 0.79). In a multivariate analysis, MTV reduction (p = 0.002) and FIGO stage (p = 0.003) were statistically significant variables associated with PFS. MTV reduction during NACT corresponded to OS = 0.05).Conclusion F-18-FDG-PET/CT is helpful in NACT response evaluation. Patients with total MTV reduction <85% during NACT might he candidates for second-line chemotherapy and clinical trials, instead of interval debulking surgery.



Last updated on 2024-26-11 at 17:33