PURPOSE: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. PATIENTS AND METHODS: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. RESULTS: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). CONCLUSIONS: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer.
PURPOSE: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. PATIENTS AND METHODS: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. RESULTS: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). CONCLUSIONS: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer.
Authors: Navesh K Sharma; Joshua S Silverman; Tianyu Li; Jonathan Cheng; Jian Q Yu; Oleh Haluszka; Walter Scott; Neal J Meropol; Steven J Cohen; Gary M Freedman; Andre A Konski Journal: Gastrointest Cancer Res Date: 2011-05
Authors: Jaffer A Ajani; Kathryn A Winter; Leonard L Gunderson; John Pedersen; Al B Benson; Charles R Thomas; Robert J Mayer; Michael G Haddock; Tyvin A Rich; Christopher G Willett Journal: Cancer Date: 2010-09-01 Impact factor: 6.860
Authors: Leonard L Gunderson; Jennifer Moughan; Jaffer A Ajani; John E Pedersen; Kathryn A Winter; Al B Benson; Charles R Thomas; Robert J Mayer; Michael G Haddock; Tyvin A Rich; Christopher G Willett Journal: Int J Radiat Oncol Biol Phys Date: 2013-09-10 Impact factor: 7.038