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SHR Neuro Cancer Cardio Lipid Metab Microb

Wilson, JM; Mukherjee, S; Brunner, TB; Partridge, M; Hawkins, MA.
Correlation of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography Parameters with Patterns of Disease Progression in Locally Advanced Pancreatic Cancer after Definitive Chemoradiotherapy.
Clin Oncol (R Coll Radiol). 2017; 29(6):370-377 Doi: 10.1016/j.clon.2017.01.038 [OPEN ACCESS]
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Co-authors Med Uni Graz: Brunner Thomas Baptist
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Abstract:: AIMS: A proportion of patients with pancreatic cancer never develop metastatic disease. We evaluated a role for ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) in identifying a subset of patients with locally advanced pancreatic cancer (LAPC) who never develop metastatic disease and only experience local disease and may therefore benefit from local treatment intensification. MATERIAL AND METHODS: Patients with histologically confirmed LAPC entered a single-centre phase II study of definitive upfront chemoradiotherapy (CRT). All patients underwent FDG-PET/CT before and 6 weeks after CRT. Tumour volume, standardised uptake values (SUV_max, SUV_peak, SUV_mean, SUV_median) and total lesion glycolysis (TLG) were measured on each scan and the response in each parameter was evaluated. The presence or absence of metastatic disease was noted on contrast-enhanced CT carried out every 3 months for 1 year and then at clinician discretion. RESULTS: Twenty-three patients with LAPC were recruited; 17/23 completed treatment and had interpretable sequential imaging. Twenty-four per cent of patients only ever experienced local disease. Median pre-CRT FDG-PET parameters were significantly lower in patients with local disease only during follow-up compared with those who developed metastatic disease: SUV_max 3.8 versus 8.6 (P=0.006), SUV_peak 2.5 versus 7.5 (P=0.002), SUV_mean 1.8 versus 3.3 (P=0.001), SUV_median 1.7 versus 3.0 (P=0.002), TLG 26.9 versus 115.9 (P=0.006). Tumour volume, post-CRT FDG-PET values and their relative change were not statistically different between local disease and metastatic disease groups. Receiver operating characteristic curves for pre-CRT FDG-PET parameters to predict those who never develop metastatic disease all had areas under the curve (AUCs) ≥ 0.932. Pre-CRT FDG-PET SUV_max < 6.2 predicted patients with local disease only during follow-up with 100.0% sensitivity and 92.3% specificity, 80.0% positive predictive value and 100% negative predictive value. CONCLUSIONS: Our findings suggest that patients with less FDG-avid tumours are less likely to metastasise and may therefore benefit from upfront local treatment intensification.
Find related publications in this database (using NLM MeSH Indexing): Adult - administration & dosage; Aged - administration & dosage; Area Under Curve - administration & dosage; Chemoradiotherapy - administration & dosage; Disease Progression - administration & dosage; Female - administration & dosage; Fluorodeoxyglucose F18 - administration & dosage; Glycolysis - administration & dosage; Humans - administration & dosage; Male - administration & dosage; Middle Aged - administration & dosage; Neoplasm Metastasis - administration & dosage; Pancreatic Neoplasms - diagnostic imaging, metabolism, pathology, therapy; Positron Emission Tomography Computed Tomography - administration & dosage; Positron-Emission Tomography - administration & dosage; Predictive Value of Tests - administration & dosage; ROC Curve - administration & dosage; Radiopharmaceuticals - administration & dosage; Tomography, X-Ray Computed - administration & dosage; Tumor Burden - administration & dosage
Find related publications in this database (Keywords): Chemoradiotherapy; FDG-PET; pancreatic cancer; treatment strategy selection