TY - JOUR
T1 - Prognostic value of 18F-FET PET imaging in re-irradiation of high-grade glioma
T2 - Results of a phase I clinical trial
AU - Moller, Soren
AU - Law, Ian
AU - Munck af Rosenschöld, Per
AU - Costa, Junia
AU - Poulsen, Hans Skovgaard
AU - Engelholm, Svend Aage
AU - Engelholm, Silke
N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background and purpose Positron emission tomography (PET) provides quantitative metabolic information and potential biomarkers of treatment outcome. We aimed to determine the prognostic value of early 18F-fluoroethyl-tyrosine (18F-FET) PET scans acquired during re-irradiation for recurrent high-grade glioma (HGG). Material and methods A phase I clinical trial of re-irradiation of HGG was carried out. MRI and 18F-FET PET were used for target delineation and follow-up. Images were acquired at baseline, during radiotherapy and 4 weeks post-treatment and compared by measuring the metabolically active biological tumor volume (BTV) and maximal activity (Tmax/B). Correlations with outcomes were assessed by multivariate Cox regression analysis. Results Thirty-one patients were included and all patients have died. The median overall survival was 7.0 mos. Both baseline BTV and baseline MRI volume (necrotic/cystic cavities subtracted) were prognostic for overall survival (OS) in multivariate analysis (HR = 1.3 p < 0.01 and HR = 1.3 p < 0.01, respectively). Early changes in BTV and Tmax/B were observed but they carried no independent prognostic information. Conclusions Baseline biological tumor volume (BTV) defined by 18F-FET PET was prognostic for OS in multivariate analysis, as was MRI volume (necrotic/cystic cavities subtracted). Tumor volume may aid in identifying patients whose life expectancy is too short to warrant re-irradiation.
AB - Background and purpose Positron emission tomography (PET) provides quantitative metabolic information and potential biomarkers of treatment outcome. We aimed to determine the prognostic value of early 18F-fluoroethyl-tyrosine (18F-FET) PET scans acquired during re-irradiation for recurrent high-grade glioma (HGG). Material and methods A phase I clinical trial of re-irradiation of HGG was carried out. MRI and 18F-FET PET were used for target delineation and follow-up. Images were acquired at baseline, during radiotherapy and 4 weeks post-treatment and compared by measuring the metabolically active biological tumor volume (BTV) and maximal activity (Tmax/B). Correlations with outcomes were assessed by multivariate Cox regression analysis. Results Thirty-one patients were included and all patients have died. The median overall survival was 7.0 mos. Both baseline BTV and baseline MRI volume (necrotic/cystic cavities subtracted) were prognostic for overall survival (OS) in multivariate analysis (HR = 1.3 p < 0.01 and HR = 1.3 p < 0.01, respectively). Early changes in BTV and Tmax/B were observed but they carried no independent prognostic information. Conclusions Baseline biological tumor volume (BTV) defined by 18F-FET PET was prognostic for OS in multivariate analysis, as was MRI volume (necrotic/cystic cavities subtracted). Tumor volume may aid in identifying patients whose life expectancy is too short to warrant re-irradiation.
KW - Journal Article
U2 - 10.1016/j.radonc.2016.08.014
DO - 10.1016/j.radonc.2016.08.014
M3 - Journal article
C2 - 27622554
SN - 0167-8140
VL - 121
SP - 132
EP - 137
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -
