Early prediction of response to first-line chemotherapy by sequential [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography in patients with advanced colorectal cancer
2009 (English)In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 20, no 6, 1057-1061 p.Article in journal (Refereed) Published
BACKGROUND: To evaluate [(18)F]-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), for early evaluation of response to palliative chemotherapy and for prediction of long-term outcome, in patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS: In a randomized trial, patients with mCRC received irinotecan-based combination chemotherapy. FDG-PET was carried out before treatment and after two cycles in 51 patients at two centers. Visual changes in tumor FDG uptake and changes measured semi-automatically, as standard uptake values (SUVs), were compared with radiological response after four and eight cycles. RESULTS: The mean baseline SUV for all tumor lesions per patient was higher in nonresponders than in responders (mean 7.4 versus 5.6, P = 0.02). There was a strong correlation between metabolic response (changes in SUV) and objective response (r = 0.57, P = 0.00001), with a sensitivity of 77% and a specificity of 76%. There was no significant correlation between metabolic response and time to progression (P = 0.5) or overall survival (P = 0.1). CONCLUSIONS: Although metabolic response assessed by FDG-PET reflects radiological tumor volume changes, the sensitivity and specificity are too low to support the routine use of PET in mCRC. Furthermore, PET failed to reflect long-term outcome and can, thus, not be used as surrogate end point for hard endpoint benefit.
Place, publisher, year, edition, pages
2009. Vol. 20, no 6, 1057-1061 p.
colorectal cancer, FDG-PET, palliative chemotherapy, prediction, response evaluation
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-105342DOI: 10.1093/annonc/mdn744ISI: 000266343900014PubMedID: 19164458OAI: oai:DiVA.org:uu-105342DiVA: diva2:221160