Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, Shanghai
C. Li1, R. Cai2, H. Shi3, and Y. Miao4; 1Ruijin hospital of Shanghai Jiao Tong University, Shanghai, China/Shanghai, China, 2Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China, 3Shanghai Jiaotong University School of Medicine, Shanghai, China/Shanghai, China, 4Ruijin hospital of Shanghai Jiao Tong University, Shanghai, Shanghai, China
Purpose/Objective(s): To determine the metabolic change of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with locally advanced cervical cancer (LACC) who treated with chemoradiotherapy (CRT). Materials/
Methods: In this prospective study (ChiCTR1900025327), stage IIb-IVa cervical cancer patients who treated with CRT, and received PET-CT scan before and after treatment were included. Post-treatment PET-CT was acceptable if it was performed three months after CRT completed. Metabolic parameters, including SUVmax, SUVmean, TLG, and MTV was extracted from the primary lesion of cervical cancer for each pre- and post-treatment PET-CT scan under SUV thresholds of 30% SUVmax, 40% SUVmax, and a fixed threshold of 2.5, respectively. Then the percentage change of these metabolic parameters was calculated to characteristic the lesion’s metabolic change. The association between metabolic parameter change and the prognosis (i.e., disease-free survival [DFS] and overall survival [OS]) was examined with univariate Cox regression as continues variables. Results: A total of 29 eligible participants were included, of whom the median age was 56 (interquartile range [IQR], 49 to 63) years, 27 (93.1%) were of squamous histology, and 16 (55%) were of stage IIIC-IVa. Eight DFS events and 5 deaths were observed after a median follow-up of 36.3 [IQR, 33.0 to 50.4] months and 36.3 [IQR, 30.0 to 44.3] months, respectively. The percentage change of SUVmax (hazard ratio [HR], 1.03 [95% CI, 1.00 to 1.06], P = 0.044), SUV mean (HR, 1.03 [95% CI, 1.00 to 1.07], P = 0.035) were significantly associated with DFS under the threshold of 40% SUVmax. The percentage change of SUVmax (HR, 1.06 [95% CI, 1.01 to 1.11], P = 0.01), SUV mean (HR, 1.07 [95% CI, 1.02 to 1.12], P = 0.009), and standard deviation of SUV (HR, 1.06 [95% CI, 1.01 to 1.10], P = 0.013) were significantly associated with OS under the threshold of 40% SUVmax. Conclusion: SUVmax, SUVmean and SUV standard deviation percentage change after CRT could be a potential biomarker with prognostic value.
