Explorative Study on the Predictive and Prognostic Value of Early Complete Metabolic Response By FDG-PET–CT During Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer

Clinical Ovarian and Other Gynecologic Cancer Pub Date : 2012-06-01 DOI:10.1016/j.cogc.2012.04.003

Andrea Angelo Martoni , Marta Rosati , Claudio Zamagni , Pierandrea De Jaco , Paolo Castellucci , Sara Quercia , Alessandra Bernardi , Stefano Fanti

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引用次数: 3

Abstract

Background and Aim

Early complete metabolic response (e-CMR) by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) during neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (AOC) could have predictive and prognostic value. The present explorative study prospectively investigated changes of dual-time FDG-PET, at baseline and after 3 cycles of NACT in patients who were not candidates for upfront debulking surgery by comparing with standard serum cancer antigen 125 (CA-125) monitoring.

Patients and Methods

Fifty consecutive patients with AOC were treated with 6 cycles of carboplatin/paclitaxel before surgery. FDG-PET and serum CA-125 were evaluated at baseline and after 3 cycles. e-CMR and early complete biochemical response (e-CBR) were defined as the normalization of the maximum standardized uptake values and serum CA-125 levels, respectively.

Results

e-CMR and e-CBR were observed in 34% and 38% of patients, respectively. At the end of NACT, an optimal pathologic response (pR) and optimal surgery with no residual tumor (R0) were achieved in 23 (46%) and 26 (52%) patients, respectively. E-CMR and e-CBR positive predictive value was 88% and 84% for pR and 88% and 89% for R0, respectively. After a median follow-up of 42 months, 41 (82%) patients had progressed and 32 (64%) died. Median progression-free survival and overall survival were 13.8 and 28.1 months, respectively. At multivariate analysis, e-CMR, but not e-CBR, showed an independent prognostic value with regard to both progression-free survival and overall survival.

Conclusions

e-CMR may predict pR and R0 surgery obtained at the end of NACT and identify patients a favorable long-term outcome.

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FDG-PET-CT对晚期卵巢癌新辅助化疗早期完全代谢反应预测及预后价值的探索性研究

背景和目的氟-18氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)在晚期卵巢癌(AOC)新辅助化疗(NACT)期间的早期完全代谢反应(e-CMR)可能具有预测和预后价值。本探索性研究通过与标准血清癌抗原125 (CA-125)监测比较，前瞻性地研究了未进行术前减脂手术的患者在基线和3个周期NACT后双时间FDG-PET的变化。患者与方法连续50例AOC患者术前给予6个周期的卡铂/紫杉醇治疗。在基线和3个周期后评估FDG-PET和血清CA-125。e-CMR和早期完全生化反应(e-CBR)分别被定义为最大标准化摄取值和血清CA-125水平的正常化。结果- cmr和e-CBR分别占34%和38%。在NACT结束时，分别有23例(46%)和26例(52%)患者达到最佳病理反应(pR)和最佳手术无肿瘤残留(R0)。pR和R0的E-CMR和e-CBR阳性预测值分别为88%和84%和88%和89%。中位随访42个月后，41例(82%)患者进展，32例(64%)死亡。中位无进展生存期和总生存期分别为13.8个月和28.1个月。在多变量分析中，e-CMR，而不是e-CBR，在无进展生存期和总生存期方面显示出独立的预后价值。结论:cmr可以预测NACT结束时获得的pR和R0手术，并确定患者良好的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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