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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...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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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. |
format | Online Article Text |
id | pubmed-8752878 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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