BIOMEDICAL IMAGING GROUP (BIG)
Laboratoire d'imagerie biomédicale (LIB)

(18F)-FDG PET/CT Parameters to Predict Survival and Recurrence in Patients with Locally Advanced Cervical Cancer Treated with Chemoradiotherapy

N. Scher, J. Castelli, A. Depeursinge, J. Bourhis, J.O. Prior, F.G. Herrera, M. Ozsahin

Cancer/Radiothérapie, vol. 22, no. 3, pp. 229-235, May 2018.

Purpose. — To identify predictive (18F)-fluorodeoxyglucose (FDG) positron emission tomography(PET)/computed tomography (CT)-based parameters for locoregional control, disease-free survival and overall survival, by testing different thresholds of metabolic tumor volume and total lesion glycolysis inpatients with locally-advanced cervical cancer.

Patients and methods. — Thirty-seven patients treated with standard chemoirradiation underwent a pre-treatment (18F)-FDG-PET/CT. Using different thresholds of maximum standardized uptake value, the following PET parameters were computed: maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume and total lesion glycolysis for primary tumor and lymph nodes and a new parameter combining the metabolic tumor volume and the distance between lymph nodes and the primary tumor, namely metabolic node distance. Correlation between PET and clinical parameters with clinical outcome (overall survival, disease-free survival, and locoregional control) was assessed using univariate and multivariate analyses (Cox model).

Results. — In univariate analyses, PET/CT parameters associated with overall survival and disease-free survival were: metabolic tumor volume and total lesion glycolysis of the primary tumor, total lesion glycolysis of lymph nodes and metabolic node distance. The most predictive threshold segmentation for metabolic tumor volume and total lesion glycolysis was 48% of maximum standardized uptake value for the primary tumor and 30% for the lymph nodes. In multivariate Cox analysis, the total lesion glycolysis of primary tumor 48% and metabolic node distance were the two independent risk factors for overall survival (P < 0.01), disease-free survival (P < 0.01) and locoregional control (P = 0.046).

Conclusion. — Total lesion glycolysis of primary tumor and distance between the invaded positive lymph node and the primary tumor seem to have the highest predictive value when compared to classical clinical prognostic parameters and may be useful to identify high risk groups at time of diagnosis and to tailor the therapeutic approach in locally-advanced cervical cancer. 

@ARTICLE(http://bigwww.epfl.ch/publications/scher1801.html,
AUTHOR="Scher, N. and Castelli, J. and Depeursinge, A. and Bourhis, J.
	and Prior, J.O. and Herrera, F.G. and Ozsahin, M.",
TITLE="($^{18}${F})-{FDG} {PET/CT} Parameters to Predict Survival and
	Recurrence in Patients with Locally Advanced Cervical Cancer Treated
	with Chemoradiotherapy",
JOURNAL="Cancer/Radioth{\'{e}}rapie",
YEAR="2018",
volume="22",
number="3",
pages="229--235",
month="May",
note="")

© 2018 Elsevier. Personal use of this material is permitted. However, permission to reprint/republish this material for advertising or promotional purposes or for creating new collective works for resale or redistribution to servers or lists, or to reuse any copyrighted component of this work in other works must be obtained from Elsevier. This material is presented to ensure timely dissemination of scholarly and technical work. Copyright and all rights therein are retained by authors or by other copyright holders. All persons copying this information are expected to adhere to the terms and constraints invoked by each author's copyright. In most cases, these works may not be reposted without the explicit permission of the copyright holder.