Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2006

Monitoring chemotherapy and radiotherapy of solid tumors

Authors: Wolfgang A. Weber, Hinrich Wieder

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Special Issue 1/2006

Abstract

PET imaging with the glucose analog fluorodeoxyglucose (FDG-PET) has been evaluated in numerous studies to monitor tumor response in patients undergoing chemo- and radiotherapy. The clinical value of FDG-PET for differentiation of residual or recurrent viable tumor and therapy-induced fibrosis or scar tissue has been documented for various solid tumors. Furthermore, there are now several reports suggesting that quantitative assessment of therapy-induced changes in tumor FDG uptake may allow prediction of tumor response and patient outcome very early in the course of therapy. In nonresponding patients, treatment may be adjusted according to the individual chemo- and radiosensitivity of the tumor tissue. Since the number of alternative treatments for solid tumors (e.g., second-line chemotherapy agents, protein kinase, or angiogenesis inhibitors) is continuously increasing, early prediction of tumor response to chemotherapy and radiotherapy by FDG-PET has enormous potential to “personalize” treatment and to reduce the side-effects and costs of ineffective therapy.

Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205–216PubMedCrossRef

Buyse M, Thirion P, Carlson RW, Burzykowski T, Molenberghs G, Piedbois P. Relation between tumour response to first-line chemotherapy and survival in advanced colorectal cancer: a meta-analysis. Meta-Analysis Group in Cancer. Lancet 2000;356:373–378PubMedCrossRef

Bruzzi P, Del Mastro L, Sormani MP, Bastholt L, Danova M, Focan C, et al. Objective response to chemotherapy as a potential surrogate end point of survival in metastatic breast cancer patients. J Clin Oncol 2005;23:5117–5125PubMedCrossRef

Ratain MJ. Phase II oncology trials: let’s be positive. Clin Cancer Res 2005;11:5661–5662PubMedCrossRef

Goffin J, Baral S, Tu D, Nomikos D, Seymour L. Objective responses in patients with malignant melanoma or renal cell cancer in early clinical studies do not predict regulatory approval. Clin Cancer Res 2005;11:5928–5934PubMedCrossRef

Salzer-Kuntschik M, Delling G, Beron G, Sigmund R. Morphological grades of regression in osteosarcoma after polychemotherapy—study COSS 80. J Cancer Res Clin Oncol 1983;106(Suppl):21–24PubMedCrossRef

Junker K, Langner K, Klinke F, Bosse U, Thomas M. Grading of tumor regression in non-small cell lung cancer: morphology and prognosis. Chest 2001;120:1584–1591PubMedCrossRef

Mandard A, Dalibard F, Mandard J, Marnay J, Henry-Amar M, Petiot J, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer 1994;73:2680–2686PubMedCrossRef

Becker K, Mueller JD, Schulmacher C, Ott K, Fink U, Busch R, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer 2003;98:1521–1530PubMedCrossRef

10.

Bielack SS, Kempf-Bielack B, Delling G, Exner GU, Flege S, Helmke K, et al. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol 2002;20:776–790PubMedCrossRef

11.

Wieder HA, Brucher BL, Zimmermann F, Becker K, Lordick F, Beer A, et al. Time course of tumor metabolic activity during chemoradiotherapy of esophageal squamous cell carcinoma and response to treatment. J Clin Oncol 2004;22:900–908PubMedCrossRef

12.

Brucher BL, Weber W, Bauer M, Fink U, Avril N, Stein HJ, et al. Neoadjuvant therapy of esophageal squamous cell carcinoma: response evaluation by positron emission tomography. Ann Surg 2001;233:300–309PubMedCrossRef

13.

Flamen P, Van Cutsem E, Lerut A, Cambier J, Haustermans K, Bormans G, et al. Positron emission tomography for assessment of the response to induction chemotherapy in locally advanced esophageal cancer. Ann Oncol 2002;13:361–368PubMedCrossRef

14.

Downey RJ, Akhurst T, Ilson D, Ginsberg R, Bains MS, Gonen M, et al. Whole body¹⁸FDG-PET and the response of esophageal cancer to induction therapy: results of a prospective trial. J Clin Oncol 2003;21:428–432PubMedCrossRef

15.

Swisher SG, Maish M, Erasmus JJ, Correa AM, Ajani JA, Bresalier R, et al. Utility of PET, CT, and EUS to identify pathologic responders in esophageal cancer. Ann Thorac Surg 2004;78:1152–60, discussion 1152–1160PubMedCrossRef

16.

Swisher SG, Erasmus J, Maish M, Correa AM, Macapinlac H, Ajani JA, et al. 2-Fluoro-2-deoxy-D-glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma. Cancer 2004;101:1776–1785PubMedCrossRef

17.

MacManus MP, Hicks RJ, Matthews JP, McKenzie A, Rischin D, Salminen EK, et al. Positron emission tomography is superior to computed tomography scanning for response assessment after radical radiotherapy or chemoradiotherapy in patients with non-small-cell lung cancer. J Clin Oncol 2003;21:1285–1292CrossRef

18.

Hellwig D, Graeter TP, Ukena D, Georg T, Kirsch CM, Schafers HJ. Value of F-18-fluorodeoxyglucose positron emission tomography after induction therapy of locally advanced bronchogenic carcinoma. J Thorac Cardiovasc Surg 2004;128:892–899PubMedCrossRef

19.

Akhurst T, Downey RJ, Ginsberg MS, Gonen M, Bains M, Korst R, et al. An initial experience with FDG-PET in the imaging of residual disease after induction therapy for lung cancer. Ann Thorac Surg 2002;73:259–64, discussion 264–266PubMedCrossRef

20.

Ryu JS, Choi NC, Fischman AJ, Lynch TJ, Mathisen DJ. FDG-PET in staging and restaging non-small cell lung cancer after neoadjuvant chemoradiotherapy: correlation with histopathology. Lung Cancer 2002;35:179–187PubMedCrossRef

21.

Cerfolio RJ, Bryant AS, Winokur TS, Ohja B, Bartolucci AA. Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non-small cell lung cancer. Ann Thorac Surg 2004;78:1903–1909, discussion 1909PubMedCrossRef

22.

Port JL, Kent MS, Korst RJ, Keresztes R, Levin MA, Altorki NK. Positron emission tomography scanning poorly predicts response to preoperative chemotherapy in non-small cell lung cancer. Ann Thorac Surg 2004;77:254–259, discussion 259PubMedCrossRef

23.

Grigsby PW, Siegel BA, Dehdashti F, Rader J, Zoberi I. Posttherapy [¹⁸F]fluorodeoxyglucose positron emission tomography in carcinoma of the cervix: response and outcome. J Clin Oncol 2004;22:2167–2171PubMedCrossRef

24.

Schuetze SM, Rubin BP, Vernon C, Hawkins DS, Bruckner JD, Conrad EU 3rd, et al. Use of positron emission tomography in localized extremity soft tissue sarcoma treated with neoadjuvant chemotherapy. Cancer 2005;103:339–348PubMedCrossRef

25.

Schulte M, Brecht-Krauss D, Werner M, Hartwig E, Sarkar MR, Keppler P, et al. Evaluation of neoadjuvant therapy response of osteogenic sarcoma using FDG PET. J Nucl Med 1999;40:1637–1643PubMed

26.

Hawkins DS, Rajendran JG, Conrad EU 3rd, Bruckner JD, Eary JF. Evaluation of chemotherapy response in pediatric bone sarcomas by [F-18]-fluorodeoxy-D-glucose positron emission tomography. Cancer 2002;94:3277–3284PubMedCrossRef

27.

Wahl RL, Zasadny K, Helvie M, Hutchins GD, Weber B, Cody R. Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol 1993;11:2101–2111PubMed

28.

Jansson T, Westlin JE, Ahlstrom H, Lilja A, Langstrom B, Bergh J. Positron emission tomography studies in patients with locally advanced and/or metastatic breast cancer: a method for early therapy evaluation? J Clin Oncol 1995;13:1470–1477PubMed

29.

Findlay M, Young H, Cunningham D, Iveson A, Cronin B, Hickish T, et al. Noninvasive monitoring of tumor metabolism using fluorodeoxyglucose and positron emission tomography in colorectal cancer liver metastases: correlation with tumor response to fluorouracil. J Clin Oncol 1996;14:700–708PubMed

30.

Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 2002;346:92–98PubMedCrossRef

31.

Honkoop AH, van Diest PJ, de Jong JS, Linn SC, Giaccone G, Hoekman K, et al. Prognostic role of clinical, pathological and biological characteristics in patients with locally advanced breast cancer. Br J Cancer 1998;77:621–626PubMed

32.

Smith IC, Welch AE, Hutcheon AW, Miller ID, Payne S, Chilcott F, et al. Positron emission tomography using [¹⁸F]-fluorodeoxy-D-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J Clin Oncol 2000;18:1676–1688PubMed

33.

Schelling M, Avril N, Nahrig J, Kuhn W, Romer W, Sattler D, et al. Positron emission tomography using [¹⁸F]fluorodeoxyglucose for monitoring primary chemotherapy in breast cancer. J Clin Oncol 2000;18:1689–1695PubMed

34.

Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Schubert EK, Tseng J, et al. Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. J Nucl Med 2003;44:1806–1814PubMed

35.

Kelsen DP, Minsky B, Smith M, Beitler J, Niedzwiecki D, Chapman D, et al. Preoperative therapy for esophageal cancer: a randomized comparison of chemotherapy versus radiation therapy. J Clin Oncol 1990;8:1352–1361PubMed

36.

Medical Research Council. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 2002;359:1727–1733CrossRef

37.

Kelsen D. Preoperative chemoradiotherapy for esophageal cancer. J Clin Oncol 2001;19:283–285PubMed

38.

Urba SG, Orringer MB, Turrisi A, Iannettoni M, Forastiere A, Strawderman M. Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol 2001;19:305–313PubMed

39.

Ajani JA, Mansfield PF, Lynch PM, Pisters PW, Feig B, Dumas P, et al. Enhanced staging and all chemotherapy preoperatively in patients with potentially resectable gastric carcinoma. J Clin Oncol 1999;17:2403–411PubMed

40.

Weber WA, Ott K, Becker K, Dittler HJ, Helmberger H, Avril NE, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging. J Clin Oncol 2001;19:3058–3065PubMed

41.

Ott K, Fink U, Becker K, Stahl A, Dittler HJ, Busch R, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial. J Clin Oncol 2003;21:4604–4610PubMedCrossRef

42.

Hoekstra CJ, Stroobants SG, Smit EF, Vansteenkiste J, van Tinteren H, Postmus PE, et al. Prognostic relevance of response evaluation using [¹⁸F]-2-fluoro-2-deoxy-D-glucose positron emission tomography in patients with locally advanced non-small-cell lung cancer. J Clin Oncol 2005;23:8362–8370PubMedCrossRef

43.

Avril N, Sassen S, Schmalfeldt B, Naehrig J, Rutke S, Weber WA, et al. Prediction of response to neoadjuvant chemotherapy by sequential F-18-fluorodeoxyglucose positron emission tomography in patients with advanced-stage ovarian cancer. J Clin Oncol 2005;23:7445–7453PubMedCrossRef

44.

Haberkorn U, Morr I, Oberdorfer F, Bellemann ME, Blatter J, Altmann A, et al. Fluorodeoxyglucose uptake in vitro: aspects of method and effects of treatment with gemcitabine. J Nucl Med 1994;35:1842–1850PubMed

45.

Higashi K, Clavo AC, Wahl RL. In vitro assessment of 2-fluoro-2-deoxy-D-glucose, L-methionine and thymidine as agents to monitor the early response of a human adenocarcinoma cell line to radiotherapy [see comments]. J Nucl Med 1993;34:773–779PubMed

46.

Rozental JM, Levine RL, Nickles RJ, Dobkin JA. Glucose uptake by gliomas after treatment. A positron emission tomographic study [see comments]. Arch Neurol 1989;46:1302–1307PubMed

47.

Maruyama I, Sadato N, Waki A, Tsuchida T, Yoshida M, Fujibayashi Y, et al. Hyperacute changes in glucose metabolism of brain tumors after stereotactic radiosurgery: a PET study. J Nucl Med 1999;40:1085–1090PubMed

48.

Mortimer JE, Dehdashti F, Siegel BA, Trinkaus K, Katzenellenbogen JA, Welch MJ. Metabolic flare: indicator of hormone responsiveness in advanced breast cancer. J Clin Oncol 2001;19:2797–2803PubMed

49.

Hicks RJ, MacManus MP, Matthews JP, Hogg A, Binns D, Rischin D, et al. Early FDG-PET imaging after radical radiotherapy for non-small-cell lung cancer: inflammatory changes in normal tissues correlate with tumor response and do not confound therapeutic response evaluation. Int J Radiat Oncol Biol Phys 2004;60:412–418PubMedCrossRef

50.

Amthauer H, Denecke T, Rau B, Hildebrandt B, Hunerbein M, Ruf J, et al. Response prediction by FDG-PET after neoadjuvant radiochemotherapy and combined regional hyperthermia of rectal cancer: correlation with endorectal ultrasound and histopathology. Eur J Nucl Med Mol Imaging 2004;31:811–819PubMedCrossRef

51.

Pottgen C, Levegrun S, Theegarten D, Marnitz S, Grehl S, Pink R, et al. Value of¹⁸F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography in non-small-cell lung cancer for prediction of pathologic response and times to relapse after neoadjuvant chemoradiotherapy. Clin Cancer Res 2006;12:97–106PubMedCrossRef

52.

Townsend DW, Carney JP, Yap JT, Hall NC. PET/CT today and tomorrow. J Nucl Med 2004;45(Suppl 1):4S–14SPubMed

53.

Goerres GW, Burger C, Kamel E, Seifert B, Kaim AH, Buck A, et al. Respiration-induced attenuation artifact at PET/CT: technical considerations. Radiology 2003;226:906–910PubMedCrossRef

54.

Pan T, Mawlawi O, Nehmeh SA, Erdi YE, Luo D, Liu HH, et al. Attenuation correction of PET images with respiration-averaged CT images in PET/CT. J Nucl Med 2005;46:1481–1487PubMed

55.

Berthelsen AK, Holm S, Loft A, Klausen TL, Andersen F, Hojgaard L. PET/CT with intravenous contrast can be used for PET attenuation correction in cancer patients. Eur J Nucl Med Mol Imaging 2005;32:1167–1175PubMedCrossRef

56.

Beer A, Wieder H, Lordick F, Ott K, Fischer M, Becker K, et al. Adenocarcinomas of the esophagogastric junction: MDCT for evaluation of early response to neoadjuvant chemotherapy. Radiology 2006;Mar 16 [Epub ahead of print]

57.

Larson SM, Erdi Y, Akhurst T, Mazumdar M, Macapinlac HA, Finn RD, et al. Tumor treatment response based on visual and quantitative changes in global tumor glycolysis using PET-FDG imaging. The Visual Response Score and the change in total lesion glycolysis. Clin Positron Imaging 1999;2:159–171PubMedCrossRef

58.

Young H, Baum R, Cremerius U, Herholz K, Hoeckstra O, Lammertsma A, et al. Measurement of clinical and sublinical tumour response using f-18-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. Eur J Cancer 1999;35:1773–1782PubMedCrossRef

59.

Minn H, Zasadny KR, Quint LE, Wahl RL. Lung cancer: reproducibility of quantitative measurements for evaluating 2-[F-18]-fluoro-2-deoxy-D-glucose uptake at PET. Radiology 1995;196:167–173PubMed

60.

Weber WA, Ziegler SI, Thodtmann R, Hanauske AR, Schwaiger M. Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med 1999;40:1771–1777PubMed

61.

Weber WA, Petersen V, Schmidt B, Tyndale-Hines L, Link T, Peschel C, et al. Positron emission tomography in non-small-cell lung cancer: prediction of response to chemotherapy by quantitative assessment of glucose use. J Clin Oncol 2003;21:2651–2657PubMedCrossRef

62.

Yamane T, Daimaru O, Ito S, Yoshiya K, Nagata T, Uchida H. Decreased¹⁸F-FDG uptake 1 day after initiation of chemotherapy for malignant lymphomas. J Nucl Med 2004;45:1838–1842PubMed

63.

Weber WA, Ott K. Imaging of esophageal and gastric cancer. Semin Oncol 2004;31:530–541PubMedCrossRef

64.

Brun E, Kjellen E, Tennvall J, Ohlsson T, Sandell A, Perfekt R, et al. FDG PET studies during treatment: prediction of therapy outcome in head and neck squamous cell carcinoma. Head Neck 2002;24:127–135PubMedCrossRef

65.

Lordick F, Weber WA, Stein HJ, Schuhmacher C, Beer A, Hennig M, et al. Individualized neoadjuvant treatment strategy in adenocarcinoma of the esophago-gastric junction (AEG): interim report on the MUNICON trial. J Clin Oncol 2004;22:328S

66.

Kunkel M, Forster GJ, Reichert TE, Kutzner J, Benz P, Bartenstein P, et al. Radiation response non-invasively imaged by [¹⁸F]FDG-PET predicts local tumor control and survival in advanced oral squamous cell carcinoma. Oral Oncol 2003;39:170–177PubMedCrossRef

Title: Monitoring chemotherapy and radiotherapy of solid tumors
Authors: Wolfgang A. Weber
Hinrich Wieder
Publication date: 01-07-2006
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue Special Issue 1/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0133-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Monitoring chemotherapy and radiotherapy of solid tumors

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Special Issue 1/2006

Use of FDG-PET to monitor response to chemotherapy and radiotherapy in patients with lymphomas

How should we analyse FDG PET studies for monitoring tumour response?

Hypoxia imaging-directed radiation treatment planning

Imaging biomarkers as surrogate endpoints for drug development

αvβ3-integrin imaging: a new approach to characterise angiogenesis?

Is 3′-deoxy-3′-18F-fluorothymidine a better marker for tumour response than 18F-fluorodeoxyglucose?