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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-05-2013 | Original Article

¹⁸F-FDG PET/CT-based treatment response evaluation in locally advanced rectal cancer: a prospective validation of long-term outcomes

Authors: Felipe A. Calvo, Claudio V. Sole, Dolores de la Mata, Luis Cabezón, Marina Gómez-Espí, Emilio Alvarez, Paz Madariaga, José L. Carreras

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2013

Abstract

Purpose

To prospectively evaluate the usefulness of ¹⁸F-FDG PET/CT) imaging for predicting histopathological response and long-term clinical outcomes in locally advanced rectal cancer (LARC).

Methods

This prospective study included 38 patients with a confirmed diagnosis of LARC (cT3-4 or cN+) who underwent ¹⁸F-FDG PET/CT before and after neoadjuvant therapy (NAT). Total mesorectal excision was scheduled 6 weeks after NAT and was followed by an expert histopathological analysis of the surgical specimen. Baseline variables and previously identified maximum FDG standardized uptake value (SUVmax) cut-off values before NAT (SUVmax_PRE ≥6) and after NAT (SUVmax_POST ≥2), and the absolute and percentage reductions from baseline SUVmax (∆SUVmax <4 and ∆SUVmax% <65 %, respectively) were applied to differentiate patients showing a metabolic tumour response from nonresponders. These features were correlated with tumour regression grade (TRG), disease-free survival (DFS) and overall survival (OS).

Results

Significantly higher 5-year DFS and OS were seen in 19 responders (TRG 3 or 4) than in 19 nonresponders (TRG 0–2; 94.4 vs. 48.8 %, p = 0.001; 94.7 vs. 63.2 %, p = 0.02, respectively). In multivariate analysis the only PET/CT SUVmax-based parameter significantly correlated with the likelihood of recurrence and survival was ∆SUV% <65 % (HR = 5.95, p = 0.02, for DFS; HR = 5.26, p = 0.04, for OS)

Conclusion

This prospective study proved that ¹⁸F-FDG PET/CT is a valuable imaging tool for assessing rectal cancer TRG and long-term prognosis, and could potentially serve as an intermediate endpoint in treatment optimization research and rectal cancer patient care.

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Title: 18F-FDG PET/CT-based treatment response evaluation in locally advanced rectal cancer: a prospective validation of long-term outcomes
Authors: Felipe A. Calvo
Claudio V. Sole
Dolores de la Mata
Luis Cabezón
Marina Gómez-Espí
Emilio Alvarez
Paz Madariaga
José L. Carreras
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2341-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

¹⁸F-FDG PET/CT-based treatment response evaluation in locally advanced rectal cancer: a prospective validation of long-term outcomes

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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