TY - JOUR
T1 - Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma
AU - Schwarz, Julie K.
AU - Siegel, Barry A.
AU - Dehdashti, Farrokh
AU - Grigsby, Perry W.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/11/21
Y1 - 2007/11/21
N2 - Context: Retrospective studies have demonstrated that the use of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) in the posttherapy evaluation of patients with cervical carcinoma is predictive of survival outcome. Objective: To validate the association between the metabolic response on the 3-month posttherapy FDG-PET and long-term survival outcome. Design, Setting, and Patients: A prospective cohort study designed to validate our previous finding that the results of a 3-month posttherapy FDG-PET are predictive of long-term clinical outcome. A total of 92 women were treated with external irradiation, brachytherapy, and concurrent chemotherapy from January 2003 through September 2006. Posttherapy whole-body FDG-PET was performed 2 to 4 months (mean, 3 months) after completion of therapy. Main Outcome Measures: The primary outcome end points were metabolic response, progression-free survival, and cause-specific survival. Results: Posttherapy FDG-PET showed a complete metabolic response in 65 patients (70%), a partial metabolic response in 15 (16%), and progressive disease in 12 (13%). Their 3-year progression-free survival rates were 78%, 33%, and0%, respectively (P<.001). Multivariate analysis demonstrated that the hazard ratio (HR) for risk of recurrence based on the posttherapy metabolic response showing progressive disease was 32.57 (95% confidence interval [CI], 10.22-103.82). A partial metabolic response had an HR of 6.30 (95% CI, 2.73-14.56). These were more predictive of survival outcome than the pretreatment lymph node status (HR, 3.54; 95% CI, 1.54-8.09). Conclusion: In this single-site study population of women with cervical cancer, 3-month posttherapy FDG uptake, as detected by whole-body PET, was predictive of survival.
AB - Context: Retrospective studies have demonstrated that the use of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) in the posttherapy evaluation of patients with cervical carcinoma is predictive of survival outcome. Objective: To validate the association between the metabolic response on the 3-month posttherapy FDG-PET and long-term survival outcome. Design, Setting, and Patients: A prospective cohort study designed to validate our previous finding that the results of a 3-month posttherapy FDG-PET are predictive of long-term clinical outcome. A total of 92 women were treated with external irradiation, brachytherapy, and concurrent chemotherapy from January 2003 through September 2006. Posttherapy whole-body FDG-PET was performed 2 to 4 months (mean, 3 months) after completion of therapy. Main Outcome Measures: The primary outcome end points were metabolic response, progression-free survival, and cause-specific survival. Results: Posttherapy FDG-PET showed a complete metabolic response in 65 patients (70%), a partial metabolic response in 15 (16%), and progressive disease in 12 (13%). Their 3-year progression-free survival rates were 78%, 33%, and0%, respectively (P<.001). Multivariate analysis demonstrated that the hazard ratio (HR) for risk of recurrence based on the posttherapy metabolic response showing progressive disease was 32.57 (95% confidence interval [CI], 10.22-103.82). A partial metabolic response had an HR of 6.30 (95% CI, 2.73-14.56). These were more predictive of survival outcome than the pretreatment lymph node status (HR, 3.54; 95% CI, 1.54-8.09). Conclusion: In this single-site study population of women with cervical cancer, 3-month posttherapy FDG uptake, as detected by whole-body PET, was predictive of survival.
UR - http://www.scopus.com/inward/record.url?scp=36349035495&partnerID=8YFLogxK
U2 - 10.1001/jama.298.19.2289
DO - 10.1001/jama.298.19.2289
M3 - Article
C2 - 18029833
AN - SCOPUS:36349035495
SN - 0098-7484
VL - 298
SP - 2289
EP - 2295
JO - JAMA
JF - JAMA
IS - 19
ER -