Evaluation of 18F-FDG-PET for Early Detection of Suboptimal Response of Rectal Cancer to Preoperative Chemoradiotherapy: A Prospective Analysis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-10

AUTHORS

Tobias Leibold, Timothy J. Akhurst, David B. Chessin, Henry W. Yeung, Homer Macapinlac, Jinru Shia, Bruce D. Minsky, Leonard B. Saltz, Elyn Riedel, Madhu Mazumdar, Philip B. Paty, Martin R. Weiser, W. Douglas Wong, Steven M. Larson, José G. Guillem

ABSTRACT

BACKGROUND: Early identification of inadequate response to preoperative chemoradiotherapy (CRT) may spare rectal cancer patients the toxicity of ineffective treatment. We prospectively evaluated tumor response with (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) early in the course of preoperative CRT. METHODS: A total of 27 prospectively accrued patients with locally advanced rectal cancer (T(3-4)/N(1)) received preoperative CRT (5040 cGy + 5FU-based chemotherapy). Patients underwent PET scanning before and 8-14 days after commencement of CRT. Scans were interpreted using 3 standard parameters: SUV(max), SUV(avg), and total lesion glycolysis (TLG) as well as an investigational parameter: visual response score (VRS). Percent pathologic response was quantified as a continuous variable. All PET parameters were correlated with pathology. Pathologic complete/near-complete response was defined as ≥95% tumor destruction, suboptimal response as <95%. Statistical analysis was performed using the Wilcoxon rank sum test and receiver operating characteristic (ROC) curve analysis. RESULTS: Of the 27 patients, 11 (41%) had pathologic complete/near-complete response; 16 (59%) had suboptimal response. SUV(max), SUV(avg), and TLG did not discriminate between responders and nonresponders. Visual response score (VRS) was statistically significantly higher for complete/near-complete responders than for suboptimal responders (65 vs. 33%, P = 0.02). Suboptimal responders were identified with 94% sensitivity and 78% accuracy using a VRS cut-off of 50%. CONCLUSIONS: In this pilot study, FDG-PET at 8-14 days after the beginning of preoperative CRT was unsuccessful at predicting pathological response with enough accuracy to justify an early change in therapy. More... »

PAGES

2783-2789

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-011-1634-2

DOI

http://dx.doi.org/10.1245/s10434-011-1634-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039303129

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21476107


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