Wolfgang P Fendler1, Mona Lehmann2, Andrei Todica2, Ken Herrmann3, Thomas Knösel4, Martin K Angele5, Hans Roland Dürr6, Josefine Rauch7, Peter Bartenstein8, Clemens C Cyran9, Marcus Hacker10, Lars H Lindner11. 1. Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany wolfgang.fendler@med.uni-muenchen.de. 2. Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany. 3. Department of Nuclear Medicine, Julius-Maximilians-University of Würzburg, Würzburg, Germany. 4. Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany. 5. Department of General, Visceral, Transplantation, Vascular, and Thoracic Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany Comprehensive Cancer Center, Ludwig-Maximilians-University of Munich, Munich, Germany Center for Bone and Soft Tissue Sarcoma (SarKUM), Ludwig-Maximilians-University of Munich, Munich, Germany. 6. Comprehensive Cancer Center, Ludwig-Maximilians-University of Munich, Munich, Germany Center for Bone and Soft Tissue Sarcoma (SarKUM), Ludwig-Maximilians-University of Munich, Munich, Germany Department of Orthopaedic Surgery, Orthopaedic Oncology, Ludwig-Maximilians-University of Munich, Munich, Germany. 7. Comprehensive Cancer Center, Ludwig-Maximilians-University of Munich, Munich, Germany Center for Bone and Soft Tissue Sarcoma (SarKUM), Ludwig-Maximilians-University of Munich, Munich, Germany Department of Radiotherapy and Radiation Oncology, Ludwig-Maximilians-University of Munich, Munich, Germany. 8. Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany Comprehensive Cancer Center, Ludwig-Maximilians-University of Munich, Munich, Germany. 9. Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany. 10. Department of Nuclear Medicine, Vienna General Hospital, Vienna, Austria; and. 11. Comprehensive Cancer Center, Ludwig-Maximilians-University of Munich, Munich, Germany Center for Bone and Soft Tissue Sarcoma (SarKUM), Ludwig-Maximilians-University of Munich, Munich, Germany Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Munich, Germany.
Abstract
UNLABELLED: We evaluated the prognostic accuracy of established PET and CT response criteria in patients with soft-tissue sarcoma (STS) after combined chemotherapy plus regional hyperthermia (RHT). METHODS: Seventy-three patients underwent (18)F-FDG PET/CT before and after 2-4 cycles of neoadjuvant chemotherapy with RHT for STS. Progression-free survival (PFS) and time to local and distant progression were among other factors correlated with response according to PET Response Criteria in Solid Tumors (PERCIST 1.0) and Response Evaluation Criteria in Solid Tumors (RECIST 1.1). RESULTS: Metabolic response by PERCIST (n = 44/73) was an independent predictor for PFS (P = 0.002; hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.18-0.68) and time to local or distant progression. Other independent predictors for PFS by multivariate analysis were adjuvant radiotherapy (P = 0.010; HR, 0.39; 95% CI, 0.20-0.80) and a baseline tumor size less than 5.7 cm (P = 0.012; HR, 0.43; 95% CI, 0.22-0.83). Response by RECIST 1.1 was seen in a small group of patients (n = 22/73) and allowed prediction of PFS for patients with sarcoma outside the abdomen (P = 0.048; HR, 0.13; 95% CI, 0.02-0.98). CONCLUSION: Metabolic response by (18)F-FDG PET predicts PFS and time to local and distant progression after 2-4 cycles of neoadjuvant chemotherapy plus RHT for STS.
UNLABELLED: We evaluated the prognostic accuracy of established PET and CT response criteria in patients with soft-tissue sarcoma (STS) after combined chemotherapy plus regional hyperthermia (RHT). METHODS: Seventy-three patients underwent (18)F-FDG PET/CT before and after 2-4 cycles of neoadjuvant chemotherapy with RHT for STS. Progression-free survival (PFS) and time to local and distant progression were among other factors correlated with response according to PET Response Criteria in Solid Tumors (PERCIST 1.0) and Response Evaluation Criteria in Solid Tumors (RECIST 1.1). RESULTS: Metabolic response by PERCIST (n = 44/73) was an independent predictor for PFS (P = 0.002; hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.18-0.68) and time to local or distant progression. Other independent predictors for PFS by multivariate analysis were adjuvant radiotherapy (P = 0.010; HR, 0.39; 95% CI, 0.20-0.80) and a baseline tumor size less than 5.7 cm (P = 0.012; HR, 0.43; 95% CI, 0.22-0.83). Response by RECIST 1.1 was seen in a small group of patients (n = 22/73) and allowed prediction of PFS for patients with sarcoma outside the abdomen (P = 0.048; HR, 0.13; 95% CI, 0.02-0.98). CONCLUSION: Metabolic response by (18)F-FDG PET predicts PFS and time to local and distant progression after 2-4 cycles of neoadjuvant chemotherapy plus RHT for STS.
Authors: Won Woo Lee; Young So; Seo Young Kang; Min-Kyung So; Haeryoung Kim; Hyun Woo Chung; Wan Seop Kim; Sang Eun Kim Journal: Oncol Lett Date: 2017-05-17 Impact factor: 2.967