Early FDG PET response assessment of preoperative radiochemotherapy in locally advanced rectal cancer: correlation with long-term outcome

Avallone, Antonio; Aloj, Luigi; Caracò, Corradina; Delrio, Paolo; Pecori, Biagio; Tatangelo, Fabiana; Scott, Nigel; Casaretti, Rossana; Gennaro, Francesca Di; Montano, Massimo; Silvestro, Lucrezia; Budillon, Alfredo; Lastoria, Secondo

doi:10.1007/s00259-012-2229-2

Cited by 53 publications

(40 citation statements)

References 48 publications

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“…In patients with LARC, PET scans were primarily performed for response assessment after [33][34][35][36]. Early prediction of histopathological response to preoperative RCT in LARC with PET/CT may offer the important clinical advantage of response-guided treatment, mainly allowing dose escalation or the use of more effective chemotherapeutic agents in nonresponder patients.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of 18F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

Leccisotti

Gambacorta

Waure

et al. 2015

Eur J Nucl Med Mol Imaging

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The early assessment of response to RCT by (18)F-FDG PET/CT can predict non-cPR allowing practical modification of preoperative treatment. Conversely, late RI is not sufficiently accurate for guiding the decision as to whether local excision or even observation is appropriate in an individual patient. Qualitative analysis of late PET/CT images is also not sensitive enough alone to rule out the presence of residual disease.

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Section: Discussionmentioning

confidence: 99%

The predictive value of 18F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

Leccisotti

Gambacorta

Waure

et al. 2015

Eur J Nucl Med Mol Imaging

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“…This choice was roughly based on our previous studies in rectal cancer (31,32). The present findings confirm that this simple threshold might be effective.…”

Section: Discussionmentioning

confidence: 99%

Early PET/CT Scan Is More Effective Than RECIST in Predicting Outcome of Patients with Liver Metastases from Colorectal Cancer Treated with Preoperative Chemotherapy Plus Bevacizumab

et al. 2013

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Markers predictive of treatment effect might be useful to improve the treatment of patients with metastatic solid tumors. Particularly, early changes in tumor metabolism measured by PET/CT with 18 F-FDG could predict the efficacy of treatment better than standard dimensional Response Evaluation Criteria In Solid Tumors (RECIST) response. Methods: We performed PET/CT evaluation before and after 1 cycle of treatment in patients with resectable liver metastases from colorectal cancer, within a phase 2 trial of preoperative FOLFIRI plus bevacizumab. For each lesion, the maximum standardized uptake value (SUV) and the total lesion glycolysis (TLG) were determined. On the basis of previous studies, a # 250% change from baseline was used as a threshold for significant metabolic response for maximum SUV and, exploratively, for TLG. Standard RECIST response was assessed with CT after 3 mo of treatment. Pathologic response was assessed in patients undergoing resection. The association between metabolic and CT/RECIST and pathologic response was tested with the McNemar test; the ability to predict progressionfree survival (PFS) and overall survival (OS) was tested with the Log-rank test and a multivariable Cox model. Results: Thirtythree patients were analyzed. After treatment, there was a notable decrease of all the parameters measured by PET/CT. Early metabolic PET/CT response (either SUV-or TLG-based) had a stronger, independent and statistically significant predictive value for PFS and OS than both CT/RECIST and pathologic response at multivariate analysis, although with different degrees of statistical significance. The predictive value of CT/RECIST response was not significant at multivariate analysis. Conclusion: PET/CT response was significantly predictive of long-term outcomes during preoperative treatment of patients with liver metastases from colorectal cancer, and its predictive ability was higher than that of CT/RECIST response after 3 mo of treatment. Such findings need to be confirmed by larger prospective trials.

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“…A cellular proliferation decrease and cell death usually happen immediately after irradiation and, over the long term, lead to an overall reduction in metabolism, including reduced glucose consumption, protein synthesis/amino acid transport, and DNA synthesis. 18 F-FDG PET, although not appropriate for detecting early tumor response to radiation, can be performed several months after completion of radiotherapy (30,31). On the other hand, DNA analogs or amino acids and their analogs, which are more specific to tumor characteristics than 18 F-FDG, may be more suitable for monitoring early radiotherapy response (10).…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Early-Stage Uptake of 3′-Deoxy-3′-¹⁸F-Fluorothymidine in Cancer Cells Treated with Charged Particle Irradiation

et al. 2015

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Early FDG PET response assessment of preoperative radiochemotherapy in locally advanced rectal cancer: correlation with long-term outcome

Abstract: This study is the first prospective long-term evaluation demonstrating that FDG PET is not only an early predictor of pathologic response but is also a valuable prognostic tool. Our results indicate the potential of FDG PET for optimizing multidisciplinary management of patients with LARC.

Cited by 53 publications

References 48 publications

The predictive value of 18F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

The predictive value of 18F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

Early PET/CT Scan Is More Effective Than RECIST in Predicting Outcome of Patients with Liver Metastases from Colorectal Cancer Treated with Preoperative Chemotherapy Plus Bevacizumab

Predictive Value of Early-Stage Uptake of 3′-Deoxy-3′-¹⁸F-Fluorothymidine in Cancer Cells Treated with Charged Particle Irradiation

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Early FDG PET response assessment of preoperative radiochemotherapy in locally advanced rectal cancer: correlation with long-term outcome

Cited by 53 publications

References 48 publications

The predictive value of 18F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

The predictive value of 18F-FDG PET/CT for assessing pathological response and survival in locally advanced rectal cancer after neoadjuvant radiochemotherapy

Early PET/CT Scan Is More Effective Than RECIST in Predicting Outcome of Patients with Liver Metastases from Colorectal Cancer Treated with Preoperative Chemotherapy Plus Bevacizumab

Predictive Value of Early-Stage Uptake of 3′-Deoxy-3′-18F-Fluorothymidine in Cancer Cells Treated with Charged Particle Irradiation

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Predictive Value of Early-Stage Uptake of 3′-Deoxy-3′-¹⁸F-Fluorothymidine in Cancer Cells Treated with Charged Particle Irradiation