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European Journal of Nuclear Medicine and Molecular Imaging

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01-07-2019 | Brachytherapy | Original Article

Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?

Authors: Marie Voglimacci, Erwan Gabiache, Amélie Lusque, Gwenaël Ferron, Anne Ducassou, Denis Querleu, Stéphanie Motton, Elodie Chantalat, Frédéric Courbon, Alejandra Martinez

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2019

Abstract

Purpose

Aim of the study was to assess impact of pretherapeutic FDG-PET/CT metabolic parameters on response to chemoradiotherapy (CRT) and survival in locally advanced cervical cancer (LACC) patients without paraaortic lymph node involvement.

Methods

LACC patients treated with CRT without macrometastatic involvement after paraaortic surgical staging were included. All patients had received at least 45 Gy radiotherapy and five cycles of platinum-based chemotherapy. High-risk histologies were excluded. Two senior nuclear physician experts in gynaecologic oncology reviewed all PET/CT exams, and extracted tumor SUVmax, MTV, and TLG (standardized uptake value, metabolic tumor volume, and total lesion glycolysis respectively). Response to CRT was assessed with a pelvic MRI done after 45 Gy. Medical charts were reviewed for clinical, pathology, and survival data.

Results

Ninety-three patients were included in the study. The overall survival (OS) rates at 2 and 5 years were 83.0% [95%CI: 72.5–89.8] and 71.2% [57.5–81.2] respectively. The RFS rates at 2 and 5 years were 72.5% [61.5–80.9] and 64.4% [52.3–74.2] respectively. Higher cervical SUVmax and TLG were significantly associated with poor response to CRT. In multivariate analysis, cervical SUVmax was the main predictive factor for OS.

Conclusion

Cervical tumor SUVmax was demonstrated to be a non-invasive prognostic biomarker for response to treatment and survival in LACC patients without paraaortic involvement. SUVmax and other PET/CT metabolic parameters require further prospective investigation to help tailoring of local treatment.

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Title: Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?
Authors: Marie Voglimacci
Erwan Gabiache
Amélie Lusque
Gwenaël Ferron
Anne Ducassou
Denis Querleu
Stéphanie Motton
Elodie Chantalat
Frédéric Courbon
Alejandra Martinez
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keyword: Brachytherapy
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4219-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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