Positron emission tomography (PET) evaluation after initial chemotherapy and radiation therapy predicts local control in rhabdomyosarcoma Journal Article
| Authors: | Dharmarajan, K. V.; Wexler, L. H.; Gavane, S.; Fox, J. J.; Schoder, H.; Tom, A. K.; Price, A. N.; Meyers, P. A.; Wolden, S. L. |
| Article Title: | Positron emission tomography (PET) evaluation after initial chemotherapy and radiation therapy predicts local control in rhabdomyosarcoma |
| Abstract: | 18-fluorodeoxyglucose positron emission tomography (PET) is already an integral part of staging in rhabdomyosarcoma. We investigated whether primary-site treatment response characterized by serial PET imaging at specific time points can be correlated with local control. We retrospectively examined 94 patients with rhabdomyosarcoma who received initial chemotherapy 15 weeks (median) before radiotherapy and underwent baseline, preradiation, and postradiation PET. Baseline PET standardized uptake values (SUVmax) and the presence or absence of abnormal uptake (termed PET-positive or PET-negative) both before and after radiation were examined for the primary site. Local relapse-free survival (LRFS) was calculated according to baseline SUVmax, PET-positive status, and PET-negative status by the Kaplan-Meier method, and comparisons were tested with the log-rank test. The median patient age was 11 years. With 3-year median follow-up, LRFS was improved among postradiation PET-negative vs PET-positive patients: 94% vs 75%, P=.02. By contrast, on baseline PET, LRFS was not significantly different for primary-site SUVmax≤7 vs >7 (median), although the findings suggested a trend toward improved LRFS: 96% for SUVmax≤7 vs 79% for SUVmax>7, P=.08. Preradiation PET also suggested a statistically insignificant trend toward improved LRFS for PET-negative (97%) vs PET-positive (81%) patients (P=.06). Negative postradiation PET predicted improved LRFS. Notably, 77% of patients with persistent postradiation uptake did not experience local failure, suggesting that these patients could be closely followed up rather than immediately referred for intervention. Negative baseline and preradiation PET findings suggested statistically insignificant trends toward improved LRFS. Additional study may further understanding of relationships between PET findings at these time points and outcome in rhabdomyosarcoma. Copyright © 2012 Elsevier Inc. All rights reserved. |
| Keywords: | adolescent; adult; child; preschool child; treatment outcome; child, preschool; disease-free survival; retrospective studies; young adult; multimodality cancer therapy; disease free survival; radiation dose; combined modality therapy; positron emission tomography; methodology; antineoplastic agent; radiopharmaceuticals; phase 2 clinical trial; antineoplastic combined chemotherapy protocols; radiotherapy dosage; pathology; retrospective study; diagnostic agent; infant; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; radiopharmaceutical agent; scintiscanning; rhabdomyosarcoma; roc curve; receiver operating characteristic |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 84 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2012-11-15 |
| Start Page: | 996 |
| End Page: | 1002 |
| Language: | English |
| PUBMED: | 22560547 |
| PROVIDER: | scopus |
| DOI: | 10.1016/j.ijrobp.2012.01.077 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 February 2013" - "Source: Scopus" |
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