Stereotactic body radiation therapy for liver oligometastases: predictive factors of local response by 18F-FDG-PET/CT.
Br J Radiol
; 91(1088): 20180058, 2018 Jul.
Article
en En
| MEDLINE
| ID: mdl-29750538
ABSTRACT
OBJECTIVE:
To investigate metabolic parameters as predictive of local response after stereotactic body radiation therapy (SBRT) for liver-oligometastases.METHODS:
Inclusion criteria of the present retrospective study were (a) liver oligometastases with controlled primary tumor; (b) absence of progressive disease ≥6 months; (c) metastases ≤ 3; (d) evaluation of SBRT-response by means of 18-fludeoxyglucose-PET/CT for at least two subsequent evaluations; (e) Karnofsky performance status >80; (f) life-expectancy >6 months. The following metabolic parameters were defined semi-quantitatively for each metastases (1) standardized uptake value (SUVmax; (2) SUV-mean; (3) metabolic tumor volume (MTV), tumor volume with a SUV ≥3, threshold 40%; (4) total lesion glycolysis (TLG), i.e. the product of SUV-mean and MTV. Local control was defined as absence of recurrence in the field of irradiation.RESULTS:
41 liver metastases were analyzed. Pre-SBRT, median SUV-max was 8.7 (range, 4.5-23.59), median SUV-mean was 4.6 (range, 3-7.5), median MTV was 5.7 cc (range, 0.9-80.6) and median total lesion glycolysis was 24.1 (range, 3.6-601.5). At statistical analysis, metastases with SUV-mean >5 (p 0.04; odds ratio 4.75, sensitivity = 50%, specificity = 82.6%, area under the curve 0.66) and SUV-max >12 (p 0.02; odds ratio 5.03, sensitivity = 69%, specificity = 70%, area under the curve = 0.69) showed higher rates of infield-failure compared to the remaining lesions.CONCLUSION:
According to current findings, pre-SBRT SUV-max and SUV-mean could be predictable of local response in liver oligometastases. Advances in knowledge Present findings could support the hypothesis that fludeoxyglucose-PET/CT may be a powerful tool to predict tumor control. Specifically, current results might be helpful for clinicians in the decision-making process regarding liver oligometastatic patient selection as well as the individual therapy stratification distinguishing between slowly local progressing patients and rapidly progressing patients.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Radiocirugia
/
Radiofármacos
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Fluorodesoxiglucosa F18
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Tomografía Computarizada por Tomografía de Emisión de Positrones
/
Neoplasias Hepáticas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Br J Radiol
Año:
2018
Tipo del documento:
Article
País de afiliación:
Italia