Evaluation of 18F-FDG-PET for early detection of suboptimal response of rectal cancer to preoperative chemoradiotherapy: A prospective analysis Journal Article
| Authors: | Leibold, T.; Akhurst, T. J.; Chessin, D. B.; Yeung, H. W.; Macapinlac, H.; Shia, J.; Minsky, B. D.; Saltz, L. B.; Riedel, E.; Mazumdar, M.; Paty, P. B.; Weiser, M. R.; Wong, W. D.; Larson, S. M.; Guillem, J. G. |
| Article Title: | Evaluation of 18F-FDG-PET for early detection of suboptimal response of rectal cancer to preoperative chemoradiotherapy: A prospective analysis |
| Abstract: | Background: Early identification of inadequate response to preoperative chemoradiotherapy (CRT) may spare rectal cancer patients the toxicity of ineffective treatment. We prospectively evaluated tumor response with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) early in the course of preoperative CRT. Methods: A total of 27 prospectively accrued patients with locally advanced rectal cancer (T3-4/N1) received preoperative CRT (5040 cGy + 5FU-based chemotherapy). Patients underwent PET scanning before and 8-14 days after commencement of CRT. Scans were interpreted using 3 standard parameters: SUVmax, SUV avg, and total lesion glycolysis (TLG) as well as an investigational parameter: visual response score (VRS). Percent pathologic response was quantified as a continuous variable. All PET parameters were correlated with pathology. Pathologic complete/near-complete response was defined as ≥95% tumor destruction, suboptimal response as <95%. Statistical analysis was performed using the Wilcoxon rank sum test and receiver operating characteristic (ROC) curve analysis. Results: Of the 27 patients, 11 (41%) had pathologic complete/near-complete response; 16 (59%) had suboptimal response. SUV max, SUVavg, and TLG did not discriminate between responders and nonresponders. Visual response score (VRS) was statistically significantly higher for complete/near-complete responders than for suboptimal responders (65 vs. 33%, P = 0.02). Suboptimal responders were identified with 94% sensitivity and 78% accuracy using a VRS cut-off of 50%. Conclusions: In this pilot study, FDG-PET at 8-14 days after the beginning of preoperative CRT was unsuccessful at predicting pathological response with enough accuracy to justify an early change in therapy. © 2011 Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 18 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2011-10-01 |
| Start Page: | 2783 |
| End Page: | 2789 |
| Language: | English |
| DOI: | 10.1245/s10434-011-1634-2 |
| PROVIDER: | scopus |
| PUBMED: | 21476107 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 3 October 2011" - "CODEN: ASONF" - "Source: Scopus" |
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