1. FDG-PET metabolic response predicts outcomes in anal cancer managed with chemoradiotherapy.
- Author
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Day FL, Link E, Ngan S, Leong T, Moodie K, Lynch C, Michael M, Winton Ed, Hogg A, Hicks RJ, and Heriot A
- Subjects
- Adult, Aged, Aged, 80 and over, Anus Neoplasms diagnostic imaging, Anus Neoplasms metabolism, Anus Neoplasms mortality, Australia epidemiology, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell metabolism, Carcinoma, Squamous Cell mortality, Chemotherapy, Adjuvant, Confounding Factors, Epidemiologic, Disease-Free Survival, Dose Fractionation, Radiation, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Staging, Proportional Hazards Models, Radiopharmaceuticals metabolism, Radiotherapy, Adjuvant, Retrospective Studies, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Anus Neoplasms drug therapy, Anus Neoplasms radiotherapy, Carcinoma, Squamous Cell drug therapy, Carcinoma, Squamous Cell radiotherapy, Fluorodeoxyglucose F18 metabolism, Positron-Emission Tomography methods
- Abstract
Background: The aim was to investigate the correlation between (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) metabolic response to chemoradiotherapy and clinical outcomes in squamous cell carcinoma (SCC) of the anus., Methods: A total of 48 patients with biopsy-proven anal SCC underwent FDG-PET scans at baseline and post chemoradiotherapy (54 Gy, concurrent 5-FU/mitomycin). Kaplan-Meier analysis was used to determine survival outcomes according to FDG-PET metabolic response., Results: In all, 79% patients (n=38) had a complete metabolic response (CMR) at all sites of disease, 15% (n=7) had a CMR in regional nodes but only partial response in the primary tumour (overall partial metabolic response (PMR)) and 6% (n=3) had progressive distant disease despite CMR locoregionally (overall no response (NR)). The 2-year progression-free survival (PFS) was 95% for patients with a CMR, 71% for PMR and 0% for NR (P<0.0001). The 5-year overall survival (OS) was 88% in CMR, 69% in PMR and 0% in NR (P<0.0001). Cox proportional hazards regression analyses for PFS and OS found significant associations for incomplete (PMR+NR) vs complete FDG-PET response to treatment only, (HR 4.1 (95% CI: 1.5-11.5, P=0.013) and 6.7 (95% CI: 2.1-21.6, P=0.002), respectively)., Conclusion: FDG-PET metabolic response to chemoradiotherapy in anal cancer is significantly associated with PFS and OS, and in this cohort incomplete FDG-PET response was a stronger predictor than T or N stage.
- Published
- 2011
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