Role of 18 F-PET/CT in Predicting Prognosis of Patients With Breast Cancer After Neoadjuvant Chemotherapy

Akimoto, Etsushi; Kadoya, Takayuki; Kajitani, Keiko; Emi, Akiko; Shigematsu, Hideo; Ohara, Masahiro; Masumoto, Norio; Okada, Minoru

doi:10.1016/j.clbc.2017.09.006

Cited by 28 publications

(27 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We excluded 16 of the 37 articles for the following reasons: palliative chemotherapy ( n = 2), neoadjuvant endocrine therapy only ( n = 1), no survival analysis ( n = 3), overlapping patient populations ( n = 8), PET for baseline assessment ( n = 1), and only kinetic analyses of dynamic PET scans ( n = 1). Thus, 21 studies with 1630 patients were included in the qualitative synthesis [ 12 – 32 ]. Eleven studies were prospectively conducted, where ten were retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

“…For the quantitative synthesis, we included only studies where HRs for metabolic responses assessed by PET scans either during or after NAC were available. A total of 17 studies (1279 patients) were included in the quantitative synthesis [ 12 , 16 – 21 , 23 – 32 ]. Of note, there was one study in which Kaplan-Meier curves were separately plotted according to the therapeutic regimen [ 19 ]; these patients were incorporated into the meta-analysis as separate cohorts.…”

Section: Resultsmentioning

confidence: 99%

“…2 . The specific number of studies at risk of bias and reasons were as follows: Five studies presented a moderate risk in selection of participants because of the retrospective study designs, lack of clarity regarding whether the patients were enrolled in a consecutive manner, and/or the unclear inclusion and exclusion criteria [ 12 , 23 , 25 , 26 , 32 ]. All studies were rated as having a low risk of attrition bias.…”

Section: Resultsmentioning

confidence: 99%

“…All studies were rated as having a low risk of attrition bias. For prognostic factor measurement, nine studies had a high risk of bias due to the use of data-dependent cut-off values [ 12 – 14 , 18 , 20 , 24 , 27 , 31 , 32 ]. Regarding outcome measurements, fifteen studies had a moderate risk of bias because the definition or methods for measuring disease recurrence were unclear [ 12 – 16 , 22 – 24 , 26 – 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…A meta-analysis directly comparing PET/CT and breast MRI reported that PET/CT has a higher sensitivity and specificity for assessment of pathological response than conventional MRI when performed before 3 cycles of NAC [ 11 ]. More recently, accumulating evidence has suggested that assessment of the metabolic response using 18 F-FDG PET or PET/CT has prognostic significance in breast cancer patients who underwent NAC [ 12 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prognostic value of 18F-FDG PET and PET/CT for assessment of treatment response to neoadjuvant chemotherapy in breast cancer: a systematic review and meta-analysis

Han

Choi

2020

Breast Cancer Res

View full text Add to dashboard Cite

Background We performed a systematic review and meta-analysis to evaluate the prognostic significance of 18F-FDG PET and PET/CT for evaluation of responses to neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods We searched PubMed, Embase, and the Cochrane Library databases until June 2020 to identify studies that assessed the prognostic value of 18F-FDG PET scans during or after NAC with regard to overall (OS) and disease-free survival (DFS). Hazard ratios (HRs) and their 95% confidence intervals (CIs) were pooled meta-analytically using a random-effects model. Results Twenty-one studies consisting of 1630 patients were included in the qualitative synthesis. Twelve studies investigated the use of PET scans for interim response evaluation (during NAC) and 10 studies assessed post-treatment PET evaluation (after NAC). The most widely evaluated parameter distinguishing metabolic responders from poor responders on interim or post-treatment PET scans was %ΔSUVmax, defined as the percent reduction of SUVmax compared to baseline PET, followed by SUVmax and complete metabolic response (CMR). For the 17 studies included in the meta-analysis, the pooled HR of metabolic responses on DFS was 0.21 (95% confidence interval [CI], 0.14–0.32) for interim PET scans and 0.31 (95% CI, 0.21–0.46) for post-treatment PET scans. Regarding the influence of metabolic responses on OS, the pooled HRs for interim and post-treatment PET scans were 0.20 (95% CI, 0.09–0.44) and 0.26 (95% CI, 0.14–0.51), respectively. Conclusions The currently available literature suggests that the use of 18F-FDG PET or PET/CT for evaluation of response to NAC provides significant predictive value for disease recurrence and survival in breast cancer patients and might allow risk stratification and guide rational management.

show abstract

Section: Resultsmentioning

confidence: 99%