TY - JOUR
T1 - 18-F-Fluorodeoxyglucose-Positron Emission Tomography Evaluation of Early Metabolic Response During Radiation Therapy for Cervical Cancer
AU - Schwarz, Julie K.
AU - Lin, Lillie L.
AU - Siegel, Barry A.
AU - Miller, Tom R.
AU - Grigsby, Perry W.
PY - 2008/12/1
Y1 - 2008/12/1
N2 - Purpose: To document changes in cervical tumor 18-F-fluorodeoxyglocose (FDG) uptake during radiation therapy and to correlate those changes with post-treatment tumor response and survival outcome. Methods and Materials: A total of 36 patients with Stage Ib1 to IIIb cervical cancer were enrolled in an institutional protocol examining the use of fluorodeoxyglucose-positron emission tomography (FDG-PET) for brachytherapy treatment planning. As part of this study, FDG-PET or PET/computed tomograpy (CT) images were obtained before, during, and after the completion of radiation therapy. Tumor metabolic responses were assessed qualitatively and semi-quantitatively by measurement of the maximal standardized uptake value (SUVmax). Results: Post-treatment FDG-PET images were obtained for 36 patients in this study. Of the patients, 29 patients had a complete metabolic response on the post-treatment PET, 4 had a partial metabolic response, and 3 had new sites of FDG uptake. Six patients had a complete metabolic response observed during radiation therapy, 26 had a partial metabolic response and 4 had stable or increased tumor metabolic activity. For patients with complete metabolic response during radiation therapy, median time to complete response was 29.5 days (range, 18-43 days). The mean cervical tumor SUVmax decreased from 11.2 (SD, 6.3; range, 2.1-38.0) pretreatment to 2.4 (SD, 2.7; range, 0-8.8) mid treatment, and 0.5 (SD, 1.7; range, 0-8.3) post-treatment. Conclusions: During radiation therapy for cervical cancer, FDG-PET can be used to monitor treatment response. Complete metabolic response during radiation therapy was observed for a subset of patients. Recommendations regarding the optimal timing of FDG-PET during treatment for cervical cancer will require further systematic study.
AB - Purpose: To document changes in cervical tumor 18-F-fluorodeoxyglocose (FDG) uptake during radiation therapy and to correlate those changes with post-treatment tumor response and survival outcome. Methods and Materials: A total of 36 patients with Stage Ib1 to IIIb cervical cancer were enrolled in an institutional protocol examining the use of fluorodeoxyglucose-positron emission tomography (FDG-PET) for brachytherapy treatment planning. As part of this study, FDG-PET or PET/computed tomograpy (CT) images were obtained before, during, and after the completion of radiation therapy. Tumor metabolic responses were assessed qualitatively and semi-quantitatively by measurement of the maximal standardized uptake value (SUVmax). Results: Post-treatment FDG-PET images were obtained for 36 patients in this study. Of the patients, 29 patients had a complete metabolic response on the post-treatment PET, 4 had a partial metabolic response, and 3 had new sites of FDG uptake. Six patients had a complete metabolic response observed during radiation therapy, 26 had a partial metabolic response and 4 had stable or increased tumor metabolic activity. For patients with complete metabolic response during radiation therapy, median time to complete response was 29.5 days (range, 18-43 days). The mean cervical tumor SUVmax decreased from 11.2 (SD, 6.3; range, 2.1-38.0) pretreatment to 2.4 (SD, 2.7; range, 0-8.8) mid treatment, and 0.5 (SD, 1.7; range, 0-8.3) post-treatment. Conclusions: During radiation therapy for cervical cancer, FDG-PET can be used to monitor treatment response. Complete metabolic response during radiation therapy was observed for a subset of patients. Recommendations regarding the optimal timing of FDG-PET during treatment for cervical cancer will require further systematic study.
KW - Brachytherapy
KW - Cervix cancer
KW - FDG-PET
KW - Radiation
KW - Response
UR - http://www.scopus.com/inward/record.url?scp=56349122461&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2008.03.040
DO - 10.1016/j.ijrobp.2008.03.040
M3 - Article
C2 - 18538498
AN - SCOPUS:56349122461
SN - 0360-3016
VL - 72
SP - 1502
EP - 1507
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 5
ER -