Association of Interim FDG-PET Imaging During Chemoradiation for Squamous Anal Canal Carcinoma With Recurrence.

Published

Journal Article

PURPOSE: Imaging parameters from 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) before and after chemoradiation therapy (CRT) for anal canal cancer correlate with clinical outcomes. This prospective, hypothesis-generating pilot study investigates the relationship between interim PET imaging during CRT for anal canal cancer and clinical outcome. METHODS AND MATERIALS: From June 2012 to August 2015, 30 patients with anal canal cancer were enrolled in a prospective clinical study of PET prior to and during CRT after ∼30 Gy. PET parameters of the primary site included maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTV and TLG were calculated based on 40% SUVmax (MTV40, TLG40) or SUV 2.5 (MTV2.5, TLG2.5) thresholds for pretreatment and interim images. Absolute and change in PET parameters were assessed for association with freedom from local and regional recurrence (FFLR) using single-predictor Cox regression models. Local and regional recurrence were primary and nodal (in-field) recurrences, respectively. RESULTS: Twenty-three patients were eligible for analysis. Patients were excluded with nonsquamous cell histology, recurrent anal cancer, and incomplete studies due to treatment toxicity or patient choice. Median follow-up was 2.5 years. Pretreatment MTV40 (HR 1.4 [95% CI 1.02-2.05]), interim MTV2.5 (1.4 [1.04-1.89]), and interim TLG2.5 (1.1 [1.01-1.21]) were associated with FFLR. CONCLUSIONS: In this prospective pilot study, interim PET parameters were associated with FFLR. These results warrant further investigation assessing the value of interim PET as a biomarker of response in the treatment of patients with anal cancer.

Full Text

Duke Authors

Cited Authors

  • Hong, JC; Cui, Y; Patel, BN; Rushing, CN; Faught, AM; Eng, JS; Higgins, K; Yin, F-F; Das, S; Czito, BG; Willett, CG; Palta, M

Published Date

  • November 15, 2018

Published In

Volume / Issue

  • 102 / 4

Start / End Page

  • 1046 - 1051

PubMed ID

  • 29891206

Pubmed Central ID

  • 29891206

Electronic International Standard Serial Number (EISSN)

  • 1879-355X

Digital Object Identifier (DOI)

  • 10.1016/j.ijrobp.2018.04.062

Language

  • eng

Conference Location

  • United States