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The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer
PURPOSE: To evaluate the role of the pre-treatment cervical and lymph node (LN) metabolic parameters of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT) for locally advanced cervical cancer (LACC) patients receiving concurrent chemoradiotherapy or radiothe...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417436/ https://www.ncbi.nlm.nih.gov/pubmed/34490094 http://dx.doi.org/10.3389/fonc.2021.698744 |
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author | Wang, Dunhuang Liu, Xiaoliang Wang, Weiping Huo, Li Pan, Qingqing Ren, Xue Zhang, Fuquan Hu, Ke |
author_facet | Wang, Dunhuang Liu, Xiaoliang Wang, Weiping Huo, Li Pan, Qingqing Ren, Xue Zhang, Fuquan Hu, Ke |
author_sort | Wang, Dunhuang |
collection | PubMed |
description | PURPOSE: To evaluate the role of the pre-treatment cervical and lymph node (LN) metabolic parameters of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT) for locally advanced cervical cancer (LACC) patients receiving concurrent chemoradiotherapy or radiotherapy. METHODS: we reviewed 125 consecutive patients with LACC who underwent pre-treatment (18)F-FDG PET/CT examination and concurrent chemoradiotherapy or radiotherapy from February 2010 to December 2015 at our institute. The mean standardized uptake value (SUVmean), maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of cervical lesion and lymph node (LN) were recorded. Receiver operator characteristic curve, C-index, Kaplan-Meier method, and Cox proportional hazards models were performed. RESULTS: The median follow-up was 62 months (range, 4-114 months). For 125 included patients with cervical cancer, the 5-year overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastasis-free survival (DMFS) rates were 83.6%, 75.1%, 92.3% and 79.9%, respectively. Cervical MTV (c-index 0.59-0.61) and cervical TLG (c-index 0.60-0.62) values calculated with a threshold of 40% SUVmax presented stronger prediction capability than cervical SUVmean (c-index 0.51-0.58) and cervical SUVmax (c-index 0.53-0.57) for OS, DFS, LC, and DMFS. In univariate analysis, cervical TLG ≥ 113.4 had worse DFS and DMFS. Cervical MTV ≥ 18.3 cm(3) had worse OS and DMFS. In multivariate analysis, cervical TLG ≥ 113.4 implied worse OS, DFS, and DMFS. In either univariate or multivariate analyses, cervical SUVmean and cervical SUVmax had no statistically significant correlation with OS, DFS, LC and DMFS. For 55 cervical cancer patients with positive LN, LN SUVmax presented strongest prediction capability for OS (c-index = 0.79), DFS (c-index = 0.72), LC (c-index = 0.62), and DMFS (c-index = 0.79). In multivariate analysis, LN SUVmax remained significant biomarker linked to OS, DFS, and DMFS. CONCLUSION: Pre-treatment cervical and LN metabolic parameters were associated with survival outcomes in patients with LACC. In our study, we found that pre-treatment cervical TLG and LN SUVmax may be important prognostic biomarkers for OS, DFS, and DMFS. However, further prospective studies with a large number of patients are required to evaluate the value of the metabolic parameters in survival outcomes prediction. |
format | Online Article Text |
id | pubmed-8417436 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84174362021-09-05 The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer Wang, Dunhuang Liu, Xiaoliang Wang, Weiping Huo, Li Pan, Qingqing Ren, Xue Zhang, Fuquan Hu, Ke Front Oncol Oncology PURPOSE: To evaluate the role of the pre-treatment cervical and lymph node (LN) metabolic parameters of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT) for locally advanced cervical cancer (LACC) patients receiving concurrent chemoradiotherapy or radiotherapy. METHODS: we reviewed 125 consecutive patients with LACC who underwent pre-treatment (18)F-FDG PET/CT examination and concurrent chemoradiotherapy or radiotherapy from February 2010 to December 2015 at our institute. The mean standardized uptake value (SUVmean), maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of cervical lesion and lymph node (LN) were recorded. Receiver operator characteristic curve, C-index, Kaplan-Meier method, and Cox proportional hazards models were performed. RESULTS: The median follow-up was 62 months (range, 4-114 months). For 125 included patients with cervical cancer, the 5-year overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastasis-free survival (DMFS) rates were 83.6%, 75.1%, 92.3% and 79.9%, respectively. Cervical MTV (c-index 0.59-0.61) and cervical TLG (c-index 0.60-0.62) values calculated with a threshold of 40% SUVmax presented stronger prediction capability than cervical SUVmean (c-index 0.51-0.58) and cervical SUVmax (c-index 0.53-0.57) for OS, DFS, LC, and DMFS. In univariate analysis, cervical TLG ≥ 113.4 had worse DFS and DMFS. Cervical MTV ≥ 18.3 cm(3) had worse OS and DMFS. In multivariate analysis, cervical TLG ≥ 113.4 implied worse OS, DFS, and DMFS. In either univariate or multivariate analyses, cervical SUVmean and cervical SUVmax had no statistically significant correlation with OS, DFS, LC and DMFS. For 55 cervical cancer patients with positive LN, LN SUVmax presented strongest prediction capability for OS (c-index = 0.79), DFS (c-index = 0.72), LC (c-index = 0.62), and DMFS (c-index = 0.79). In multivariate analysis, LN SUVmax remained significant biomarker linked to OS, DFS, and DMFS. CONCLUSION: Pre-treatment cervical and LN metabolic parameters were associated with survival outcomes in patients with LACC. In our study, we found that pre-treatment cervical TLG and LN SUVmax may be important prognostic biomarkers for OS, DFS, and DMFS. However, further prospective studies with a large number of patients are required to evaluate the value of the metabolic parameters in survival outcomes prediction. Frontiers Media S.A. 2021-08-19 /pmc/articles/PMC8417436/ /pubmed/34490094 http://dx.doi.org/10.3389/fonc.2021.698744 Text en Copyright © 2021 Wang, Liu, Wang, Huo, Pan, Ren, Zhang and Hu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Wang, Dunhuang Liu, Xiaoliang Wang, Weiping Huo, Li Pan, Qingqing Ren, Xue Zhang, Fuquan Hu, Ke The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer |
title | The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer |
title_full | The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer |
title_fullStr | The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer |
title_full_unstemmed | The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer |
title_short | The Role of the Metabolic Parameters of (18)F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer |
title_sort | role of the metabolic parameters of (18)f-fdg pet/ct in patients with locally advanced cervical cancer |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417436/ https://www.ncbi.nlm.nih.gov/pubmed/34490094 http://dx.doi.org/10.3389/fonc.2021.698744 |
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