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Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy

PURPOSE: Early positron emission tomography–derived metrics post–oligometastasis radioablation may predict impending local relapses (LRs), providing a basis for a timely ablation. METHODS AND MATERIALS: Positron emission tomography data of 623 lesions treated with either 24 Gy single-dose radiation...

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Autores principales: Greco, Carlo, Pares, Oriol, Pimentel, Nuno, Louro, Vasco, Morales, Javier, Nunes, Beatriz, Antunes, Inês, Vasconcelos, Ana Luisa, Kociolek, Justyna, Castanheira, Joana, Oliveira, Carla, Silva, Angelo, Vaz, Sofia, Oliveira, Francisco, Carrasquinha, Eunice, Costa, Durval, Fuks, Zvi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752878/
https://www.ncbi.nlm.nih.gov/pubmed/35036636
http://dx.doi.org/10.1016/j.adro.2021.100864
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author Greco, Carlo
Pares, Oriol
Pimentel, Nuno
Louro, Vasco
Morales, Javier
Nunes, Beatriz
Antunes, Inês
Vasconcelos, Ana Luisa
Kociolek, Justyna
Castanheira, Joana
Oliveira, Carla
Silva, Angelo
Vaz, Sofia
Oliveira, Francisco
Carrasquinha, Eunice
Costa, Durval
Fuks, Zvi
author_facet Greco, Carlo
Pares, Oriol
Pimentel, Nuno
Louro, Vasco
Morales, Javier
Nunes, Beatriz
Antunes, Inês
Vasconcelos, Ana Luisa
Kociolek, Justyna
Castanheira, Joana
Oliveira, Carla
Silva, Angelo
Vaz, Sofia
Oliveira, Francisco
Carrasquinha, Eunice
Costa, Durval
Fuks, Zvi
author_sort Greco, Carlo
collection PubMed
description PURPOSE: Early positron emission tomography–derived metrics post–oligometastasis radioablation may predict impending local relapses (LRs), providing a basis for a timely ablation. METHODS AND MATERIALS: Positron emission tomography data of 623 lesions treated with either 24 Gy single-dose radiation therapy (SDRT) (n = 475) or 3 ×  9 Gy stereotactic body radiation therapy (SBRT) (n = 148) were analyzed in a training data set (n = 246) to obtain optimal cutoffs for pretreatment maximum standardized uptake value (SUV(max)) and its 3-month posttreatment decline (ΔSUV(max)) in predicting LR risk, validated in a data set unseen to testing (n = 377). RESULTS: At a median of 21.7 months, 91 lesions developed LRs: 39 of 475 (8.2%) after SDRT and 52 of 148 (35.1%) after SBRT. The optimal cutoff values were 12 for SUV(max) and –75% for ΔSUV(max). Bivariate SUV(max)/ΔSUV(max) permutations rendered a 3-tiered LR risk stratification of dual-favorable (low risk), 1 adverse (intermediate risk) and dual-adverse (high risk). Actuarial 5-year local relapse-free survival rates were 93.9% versus 89.6% versus 57.1% (P < .0001) and 76.1% versus 48.3% versus 8.2% (P < .0001) for SDRT and SBRT, respectively. The SBRT area under the ROC curve was 0.71 (95% CI, 0.61-0.79) and the high-risk subgroup yielded a 76.5% true positive LR prediction rate. CONCLUSIONS: The SBRT dual-adverse SUV(max)/ΔSUV(max) category LR prediction power provides a basis for prospective studies testing whether a timely ablation of impending LRs affects oligometastasis outcomes.
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spelling pubmed-87528782022-01-14 Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy Greco, Carlo Pares, Oriol Pimentel, Nuno Louro, Vasco Morales, Javier Nunes, Beatriz Antunes, Inês Vasconcelos, Ana Luisa Kociolek, Justyna Castanheira, Joana Oliveira, Carla Silva, Angelo Vaz, Sofia Oliveira, Francisco Carrasquinha, Eunice Costa, Durval Fuks, Zvi Adv Radiat Oncol Scientific Article PURPOSE: Early positron emission tomography–derived metrics post–oligometastasis radioablation may predict impending local relapses (LRs), providing a basis for a timely ablation. METHODS AND MATERIALS: Positron emission tomography data of 623 lesions treated with either 24 Gy single-dose radiation therapy (SDRT) (n = 475) or 3 ×  9 Gy stereotactic body radiation therapy (SBRT) (n = 148) were analyzed in a training data set (n = 246) to obtain optimal cutoffs for pretreatment maximum standardized uptake value (SUV(max)) and its 3-month posttreatment decline (ΔSUV(max)) in predicting LR risk, validated in a data set unseen to testing (n = 377). RESULTS: At a median of 21.7 months, 91 lesions developed LRs: 39 of 475 (8.2%) after SDRT and 52 of 148 (35.1%) after SBRT. The optimal cutoff values were 12 for SUV(max) and –75% for ΔSUV(max). Bivariate SUV(max)/ΔSUV(max) permutations rendered a 3-tiered LR risk stratification of dual-favorable (low risk), 1 adverse (intermediate risk) and dual-adverse (high risk). Actuarial 5-year local relapse-free survival rates were 93.9% versus 89.6% versus 57.1% (P < .0001) and 76.1% versus 48.3% versus 8.2% (P < .0001) for SDRT and SBRT, respectively. The SBRT area under the ROC curve was 0.71 (95% CI, 0.61-0.79) and the high-risk subgroup yielded a 76.5% true positive LR prediction rate. CONCLUSIONS: The SBRT dual-adverse SUV(max)/ΔSUV(max) category LR prediction power provides a basis for prospective studies testing whether a timely ablation of impending LRs affects oligometastasis outcomes. Elsevier 2021-12-05 /pmc/articles/PMC8752878/ /pubmed/35036636 http://dx.doi.org/10.1016/j.adro.2021.100864 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Scientific Article
Greco, Carlo
Pares, Oriol
Pimentel, Nuno
Louro, Vasco
Morales, Javier
Nunes, Beatriz
Antunes, Inês
Vasconcelos, Ana Luisa
Kociolek, Justyna
Castanheira, Joana
Oliveira, Carla
Silva, Angelo
Vaz, Sofia
Oliveira, Francisco
Carrasquinha, Eunice
Costa, Durval
Fuks, Zvi
Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy
title Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy
title_full Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy
title_fullStr Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy
title_full_unstemmed Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy
title_short Positron Emission Tomography–Derived Metrics Predict the Probability of Local Relapse After Oligometastasis-Directed Ablative Radiation Therapy
title_sort positron emission tomography–derived metrics predict the probability of local relapse after oligometastasis-directed ablative radiation therapy
topic Scientific Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752878/
https://www.ncbi.nlm.nih.gov/pubmed/35036636
http://dx.doi.org/10.1016/j.adro.2021.100864
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