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FDG-PET metabolic response predicts outcomes in anal cancer managed with chemoradiotherapy.
- Source :
-
British journal of cancer [Br J Cancer] 2011 Aug 09; Vol. 105 (4), pp. 498-504. Date of Electronic Publication: 2011 Jul 26. - Publication Year :
- 2011
-
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.<br />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.<br />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).<br />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.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1532-1827
- Volume :
- 105
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- British journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 21792197
- Full Text :
- https://doi.org/10.1038/bjc.2011.274