Is the Standardized Uptake Value of FDG-PET/CT Predictive of Pathological Complete Response in Locally Advanced Rectal Cancer Treated with Capecitabine-Based Neoadjuvant Chemoradiation?

被引：20

作者：

Bampo, Chiara ^{[1
]}

Alessi, Alessandra ^{[1
]}

Fantini, Simona ^{[2
]}

Bertarelli, Gaia ^{[5
]}

de Braud, Filippo ^{[3
]}

Bombardieri, Emilio ^{[1
]}

Valvo, Francesca ^{[2
]}

Crippa, Flavio ^{[1
]}

Di Bartolomeo, Maria ^{[3
]}

Mariani, Luigi ^{[5
]}

Milione, Massimo ^{[4
]}

Biondani, Pamela ^{[3
]}

Avuzzi, Barbara ^{[2
]}

Chiruzzi, Chiara ^{[2
]}

Pietrantonio, Filippo ^{[3
]}

机构：

[1] Fdn IRCCS Ist Nazl Tumori, Dept Nucl Med, IT-20133 Milan, Italy

[2] Fdn IRCCS Ist Nazl Tumori, Dept Radiat Oncol, IT-20133 Milan, Italy

[3] Fdn IRCCS Ist Nazl Tumori, Dept Med Oncol, IT-20133 Milan, Italy

[4] Fdn IRCCS Ist Nazl Tumori, Dept Pathol, IT-20133 Milan, Italy

[5] Fdn IRCCS Ist Nazl Tumori, Med Stat & Biometry Unit, IT-20133 Milan, Italy

来源：

ONCOLOGY | 2013年 / 84卷 / 04期

关键词：

PET; Complete response; Rectal cancer; Radiochemotherapy; Predictive factor; Capecitabine; Pathology; POSITRON-EMISSION-TOMOGRAPHY; LONG-TERM ANALYSIS; PREOPERATIVE CHEMORADIATION; COMPUTED-TOMOGRAPHY; NONOPERATIVE TREATMENT; ENDORECTAL ULTRASOUND; METABOLIC-RESPONSE; TUMOR-REGRESSION; F-18-FDG PET; SEE POLICY;

D O I：

10.1159/000345601

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: Our aim was to assess FDG-PET/CT as a surrogate biomarker of the pathological complete response in locally advanced rectal cancer treated with neoadjuvant chemoradiation. Methods: T3-4 and/or N+ rectal cancer patients were treated prospectively with capecitabine-based chemoradiation and total mesorectal excision 7-8 weeks later. FDG-PET/CT uptake was obtained at baseline, after 2 weeks, and 6 weeks following treatment completion, calculating the maximum standardized uptake value (SUV) and percentage difference to identify the early and late metabolic 'response index'. Results: Thirty-one patients were treated from January 2009 to January 2012 at the Istituto Nazionale dei Tumori of Milan. One patient was excluded due to surgery refusal. The pathological complete response rate was 30%. Early FDG-PET/CT was performed in 24 consenting patients and failed to show predictive utility. On the contrary, significant differences in late SUV value and response index were observed between complete and noncomplete pathological responders (p = 0.0006 and 0.03). In multivariate analysis including most relevant SUV parameters, none of them was independently associated with a pathological complete response. With receiver operating characteristic curve analysis, a late SUV threshold <5.4 had 81% sensitivity and 100% specificity, with 90% overall accuracy. Conclusions: We evidenced a possible predictive role of late FDG-PET/CT for the assessment of pathological response in locally advanced rectal cancer following neoadjuvant chemoradiation. Copyright (C) 2013 S. Karger AG, Basel

引用

页码：191 / 199

页数：9