Clinical outcomes in cervical cancer patients treated by FDG-PET/CT-based 3-dimensional planning for the first brachytherapy session

Oh, Dongryul; Huh, Seung Jae; Park, Won; Ju, Sang Gyu; Nam, Heerim; Lee, Jeong Eun

doi:10.1097/md.0000000000003895

Cited by 16 publications

(20 citation statements)

References 22 publications

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“…The median overall treatment time and the interval between EBRT and IGBT were 51 days (IQR, 49.0 to 54.5) and 33 days (IQR, 30.0 to 39.0), respectively. The detailed procedure of PET-based IGBT has been described previously [ 2 , 3 ].…”

Section: Methodsmentioning

confidence: 99%

“…The detailed procedure of PET-based IGBT has been described previously. [2,3] After the gross tumor volume was delineated based on IGBT planning FDG-PET (PETIGBT), high-risk clinical target volume (HRCTV) was defined according to the GEC-ESTRO guidelines. [10] Briefly, the HRCTV included the gross tumor volume with a 1-cm margin, clinically suspected lesion, and entire cervix.…”

Section: Treatmentmentioning

confidence: 99%

“…However, magnetic resonance imaging (MRI) is most frequently used for image-guided brachytherapy (IGBT) in clinical practice. We have previously reported the feasibility of PET-based IGBT [ 2 , 3 ]. Biological information on FDG-PET could help visualize metabolic active region that could complement the poor contrast resolution of computed tomography (CT)–guided IGBT.…”

Section: Introductionmentioning

confidence: 99%

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Early Metabolic Response Assessed Using 18F-FDG-PET/CT for Image-Guided Intracavitary Brachytherapy Can Better Predict Treatment Outcomes in Patients with Cervical Cancer

et al. 2021

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Purpose This study aimed to identify the prognostic value of early metabolic response assessed using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) during radiation therapy (RT) for cervical cancer.Materials and Methods We identified 116 patients treated with definitive RT, including FDG-PET/CT–guided intracavitary brachytherapy, between 2009 and 2018. We calculated parameters including maximum (SUVmax) and mean standardized uptake values (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for baseline FDG-PET/CT (PETbase) and image-guided brachytherapy planning FDG-PET/CT (PETIGBT). Multivariable analyses of disease-free survival (DFS) and overall survival (OS) were performed.Results We observed a time-dependent decrease in PET parameters between PETbase and PETIGBT; ΔSUVmax, ΔSUVmean, ΔMTV, and ΔTLG were 65%, 61%, 78%, and 93%, respectively. With a median follow-up of 59.5 months, the 5-year DFS and OS rates were 66% and 79%, respectively. Multivariable analysis demonstrated that ΔSUVmax ≥ 50% was associated with favorable DFS (hazard ratio [HR], 2.56; 95% confidence interval [CI], 1.14 to 5.77) and OS (HR, 5.14; 95% CI, 1.55 to 17.01). Patients with ΔSUVmax ≥ 50% (n=87) showed better DFS and OS than those with ΔSUVmax < 50% (n=29) (DFS, 76% vs. 35%, p < 0.001; OS, 90% vs. 41%, p < 0.001, respectively). Adenocarcinoma was frequently observed in ΔSUVmax < 50% compared to ΔSUVmax ≥ 50% (27.6% vs. 10.3%, p=0.003). In addition, models incorporating metabolic parameters showed improved accuracy for predicting DFS (p=0.012) and OS (p=0.004) than models with clinicopathologic factors.Conclusion Changes in metabolic parameters, especially those in SUVmax by > 50%, can help improve survival outcome predictions for patients with cervical cancer treated with definitive RT.

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Section: Methodsmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early Metabolic Response Assessed Using 18F-FDG-PET/CT for Image-Guided Intracavitary Brachytherapy Can Better Predict Treatment Outcomes in Patients with Cervical Cancer

et al. 2021

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“…: hematuria and contracted bladder). More rare adverse events are pelvic insufficiency fracture, vaginal stenosis, lymphedema and neuropathy [52][53][54][55][56][57][58][59][60].…”

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confidence: 99%

Radical Radiotherapy of Locally Advanced Cervix Uteri Carcinoma

2021

Archives of Cancer Biology and Therapy

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External beam radiotherapy with concomitant platinum-based chemotherapy followed by brachytherapy is defined as radical radiotherapy of cervix uteri carcinoma. Radical radiotherapy is the gold standard treatment for locally advanced cervix uteri carcinoma. The rates of survival and treatment-related adverse events in patients with cervix uteri carcinoma are affected by both stage of disease and treatment. Both should be optimal in proportion to the available facilities. Here, recommendations from the current literature are presented.

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“…In the article, “Clinical outcomes in cervical cancer patients treated by FDG-PET/CT-based 3-dimensional planning for the first brachytherapy session”, [1] which appeared in Volume 95, Issue 25 of Medicine , Dr. Heerim Nam's affiliation appears incorrectly and should be Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.…”

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confidence: 99%