"\"Markers predictive of treatment effect might be useful to improve the treatment of patients with metastatic solid tumors. Particularly, early changes in tumor metabolism measured by PET\\\/CT with F-18-FDG could predict the efficacy of treatment better than standard dimensional Response Evaluation Criteria In Solid Tumors (RECIST) response. Methods: We performed PET\\\/CT evaluation before and after 1 cycle of treatment in patients with resectable liver metastases from colorectal cancer, within a phase 2 trial of preoperative FOLFIRI plus bevacizumab. For each lesion, the maximum standardized uptake value (SUV) and the total lesion glycolysis (TLG) were determined. On the basis of previous studies, a <=-50% change from baseline was used as a threshold for significant metabolic response for maximum SUV and, exploratively, for TLG. Standard RECIST response was assessed with CT after 3 mo of treatment. Pathologic response was assessed in patients undergoing resection. The association between metabolic and CT\\\/RECIST and pathologic response was tested with the McNemar test; the ability to predict progression-free survival (PFS) and overall survival (OS) was tested with the Log-rank test and a multivariable Cox model. Results: Thirty-three patients were analyzed. After treatment, there was a notable decrease of all the parameters measured by PET\\\/CT. Early metabolic PET\\\/CT response (either SUV- or TLG-based) had a stronger, independent and statistically significant predictive value for PFS and OS than both CT\\\/RECIST and pathologic response at multivariate analysis, although with different degrees of statistical significance. The predictive value of CT\\\/RECIST response was not significant at multivariate analysis. Conclusion: PET\\\/CT response was significantly predictive of long-term outcomes during preoperative treatment of patients with liver metastases from colorectal cancer, and its predictive ability was higher than that of CT\\\/RECIST response after 3 mo of treatment. Such findings need to be confirmed by larger prospective trials.\""

Early PET/CT Scan Is More Effective Than RECIST in Predicting Outcome of Patients with Liver Metastases from Colorectal Cancer Treated with Preoperative Chemotherapy Plus Bevacizumab

SIGNORIELLO, Simona;GALLO, Ciro;
2013

Abstract

"\"Markers predictive of treatment effect might be useful to improve the treatment of patients with metastatic solid tumors. Particularly, early changes in tumor metabolism measured by PET\\\/CT with F-18-FDG could predict the efficacy of treatment better than standard dimensional Response Evaluation Criteria In Solid Tumors (RECIST) response. Methods: We performed PET\\\/CT evaluation before and after 1 cycle of treatment in patients with resectable liver metastases from colorectal cancer, within a phase 2 trial of preoperative FOLFIRI plus bevacizumab. For each lesion, the maximum standardized uptake value (SUV) and the total lesion glycolysis (TLG) were determined. On the basis of previous studies, a <=-50% change from baseline was used as a threshold for significant metabolic response for maximum SUV and, exploratively, for TLG. Standard RECIST response was assessed with CT after 3 mo of treatment. Pathologic response was assessed in patients undergoing resection. The association between metabolic and CT\\\/RECIST and pathologic response was tested with the McNemar test; the ability to predict progression-free survival (PFS) and overall survival (OS) was tested with the Log-rank test and a multivariable Cox model. Results: Thirty-three patients were analyzed. After treatment, there was a notable decrease of all the parameters measured by PET\\\/CT. Early metabolic PET\\\/CT response (either SUV- or TLG-based) had a stronger, independent and statistically significant predictive value for PFS and OS than both CT\\\/RECIST and pathologic response at multivariate analysis, although with different degrees of statistical significance. The predictive value of CT\\\/RECIST response was not significant at multivariate analysis. Conclusion: PET\\\/CT response was significantly predictive of long-term outcomes during preoperative treatment of patients with liver metastases from colorectal cancer, and its predictive ability was higher than that of CT\\\/RECIST response after 3 mo of treatment. Such findings need to be confirmed by larger prospective trials.\""
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11591/321052
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