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A score combining baseline neutrophilia and primary tumor SUVpeak measured from FDG PET is associated with outcome in locally advanced cervical cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

We investigated whether a score combining baseline neutrophilia and a PET biomarker could predict outcome in patients with locally advanced cervical cancer (LACC).

Methods

Patients homogeneously treated with definitive chemoradiation plus image-guided adaptive brachytherapy (IGABT) between 2006 and 2013 were analyzed retrospectively. We divided patients into two groups depending on the PET device used: a training set (TS) and a validation set (VS). Primary tumors were semi-automatically delineated on PET images, and 11 radiomics features were calculated (LIFEx software). A PET radiomic index was selected using the time-dependent area under the curve (td-AUC) for 3-year local control (LC). We defined the neutrophil SUV grade (NSG = 0, 1 or 2) score as the number of risk factors among (i) neutrophilia (neutrophil count >7 G/L) and (ii) high risk defined from the PET radiomic index. The NSG prognostic value was evaluated for LC and overall survival (OS).

Results

Data from 108 patients were analyzed. Estimated 3-year LC was 72% in the TS (n = 69) and 65% in the VS (n = 39). In the TS, SUVpeak was selected as the most LC-predictive biomarker (td-AUC = 0.75), and was independent from neutrophilia (p = 0.119). Neutrophilia (HR = 2.6), high-risk SUVpeak (SUVpeak > 10, HR = 4.4) and NSG = 2 (HR = 9.2) were associated with low probability of LC in TS. In multivariate analysis, NSG = 2 was independently associated with low probability of LC (HR = 7.5, p < 0.001) and OS (HR = 5.8, p = 0.001) in the TS. Results obtained in the VS (HR = 5.2 for OS and 3.5 for LC, p < 0.02) were promising.

Conclusion

This innovative scoring approach combining baseline neutrophilia and a PET biomarker provides an independent prognostic factor to consider for further clinical investigations.

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Authors and Affiliations

  1. Radiation Oncology Department, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, F-94805, Villejuif, France

    Antoine Schernberg, Sylvain Reuze, Roger Sun, Alexandre Escande, Christine Haie-Meder, Eric Deutsch, Cyrus Chargari & Charlotte Robert

  2. INSERM, U1030, F-94805, Villejuif, France

    Antoine Schernberg, Sylvain Reuze, Fanny Orlhac, Roger Sun, Elaine Limkin, Eric Deutsch, Cyrus Chargari & Charlotte Robert

  3. Univ Paris Sud, Université Paris-Saclay, F-94270, Le Kremlin-Bicêtre, France

    Sylvain Reuze, Elaine Limkin, Eric Deutsch & Charlotte Robert

  4. Department of Medical Physics, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France

    Sylvain Reuze & Charlotte Robert

  5. IMIV, CEA, Inserm, CNRS, Univ. Paris-Sud, Université Paris-Saclay, CEA-SHFJ, Orsay, France

    Fanny Orlhac & Irène Buvat

  6. Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France

    Laurent Dercle

  7. INSERM, U1015, F-94805, Villejuif, France

    Laurent Dercle

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  1. Antoine Schernberg
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Correspondence to Charlotte Robert.

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Schernberg, A., Reuze, S., Orlhac, F. et al. A score combining baseline neutrophilia and primary tumor SUVpeak measured from FDG PET is associated with outcome in locally advanced cervical cancer. Eur J Nucl Med Mol Imaging 45, 187–195 (2018). https://doi.org/10.1007/s00259-017-3824-z

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