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Treatment Strategies Guided by [18F]FDG-PET/CT in Patients with Locally Advanced Cervical Cancer and [18F]FDG-Positive Lymph Nodes.
Olthof, Ester P; Wenzel, Hans H B; van der Velden, Jacobus; Stalpers, Lukas J A; Mom, Constantijne H; van der Aa, Maaike A.
Afiliación
  • Olthof EP; Department of Research & Development, Netherlands Comprehensive Cancer Organisation, 3511 LC Utrecht, The Netherlands.
  • Wenzel HHB; Centre for Gynaecologic Oncology Amsterdam (CGOA), Department of Gynaecological Oncology, Amsterdam University Medical Centre, 1081 HV Amsterdam, The Netherlands.
  • van der Velden J; Department of Research & Development, Netherlands Comprehensive Cancer Organisation, 3511 LC Utrecht, The Netherlands.
  • Stalpers LJA; Centre for Gynaecologic Oncology Amsterdam (CGOA), Department of Gynaecological Oncology, Amsterdam University Medical Centre, 1081 HV Amsterdam, The Netherlands.
  • Mom CH; Department of Radiation Oncology, Amsterdam University Medical Centre, 1055 AZ Amsterdam, The Netherlands.
  • van der Aa MA; Centre for Gynaecologic Oncology Amsterdam (CGOA), Department of Gynaecological Oncology, Amsterdam University Medical Centre, 1081 HV Amsterdam, The Netherlands.
Cancers (Basel) ; 16(4)2024 Feb 08.
Article en En | MEDLINE | ID: mdl-38398108
ABSTRACT

BACKGROUND:

Modern treatment guidelines for women with advanced cervical cancer recommend staging using 2-deoxy-2-[18F]fluoro-D-glucose positron emission computed tomography ([18F]FDG-PET/CT). However, the risk of false-positive nodes and therapy-related adverse events requires caution in treatment planning. Using data from the Netherlands Cancer Registry (NCR), we estimated the impact of [18F]FDG-PET/CT on treatment management in women with locally advanced cervical cancer, i.e., on nodal boosting, field extension, and/or debulking in cases of suspected lymph nodes.

METHODS:

Women diagnosed between 2009 and 2017, who received chemoradiotherapy for International Federation of Gynaecology and Obstetrics (2009) stage IB2, IIA2-IVB cervical cancer with an [18F]FDG-positive node, were retrospectively selected from the NCR database. Patients with pathological nodal examination before treatment were excluded. The frequency of nodal boosting, extended-field radiotherapy, and debulking procedures applied to patients with [18F]FDG-positive lymph nodes was evaluated.

RESULTS:

Among the 434 eligible patients with [18F]FDG-positive nodes, 380 (88%) received interventions targeting these lymph nodes 84% of these 380 patients received nodal boosting, 78% extended-field radiotherapy, and 12% debulking surgery. [18F]FDG-positive nodes in patients receiving these treatments were more likely to be classified as suspicious than inconclusive (p = 0.009), located in the para-aortic region (p < 0.001), and larger (p < 0.001) than in patients who did not receive these treatments.

CONCLUSION:

While existing guidelines advocate [18F]FDG-PET/CT-guided treatment planning for the management of advanced cervical cancer, this study highlights that not all cases of [18F]FDG-positive nodes received an intervention, possibly due to the risk of false-positive results. Improvement of nodal staging may reduce suboptimal treatment planning.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cancers (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cancers (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos
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