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Roles of posttherapy 18F-FDG PET/CT in patients with advanced squamous cell carcinoma of the uterine cervix receiving concurrent chemoradiotherapy

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

Abstract

Purpose

To assess the clinical roles of [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) performed 2-3 months after completion of concurrent chemoradiotherapy (CCRT), along with pretherapy characteristics, in patients with advanced squamous cell carcinoma of the uterine cervix enrolled in a prospective randomized clinical trial.

Methods

Posttherapy PET/CT in patients with advanced FIGO stage or positive pelvic or para-aortic lymph node (PALN) defined on pretherapy PET/CT was classified as positive, equivocal, or negative. Overall survival (OS) rates between patients with different PET/CT results are compared. Pretherapy characteristics are examined for association with posttherapy PET/CT results and for prognostic significance in patients with equivocal or negative PET/CT.

Results

PET/CT scans (n = 55) were positive, equivocal and negative in 9, 13 and 33 patients, respectively. All patients with positive scans were confirmed to have residual or metastatic disease and died despite salvage therapies. There is a significant OS difference between patients with positive and equivocal scans (P < .001) but not between patients with equivocal and negative scans (P = .411). Positive pretherapy PALN is associated with positive posttherapy PET/CT (P = .033) and predicts a poorer survival in patients with equivocal or negative posttherapy PET/CT (P < .001).

Conclusions

Positive PET/CT 2-3 months posttherapy implies treatment failure and novel therapy is necessary to improve outcomes for such patients. A more intense posttherapy surveillance may be warranted in patients with positive pretherapy PALN.

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Funding

This study was funded by Chang Gung Memorial Hospital, Linkou (CMRPG381141 and CMRPG381142).

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan

    Feng-Yuan Liu, Yu-Chen Chang & Tzu-Chen Yen

  2. Gynecologic Cancer Research Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan

    Feng-Yuan Liu, Chun-Chieh Wang, Angel Chao, Hung-Hsueh Chou, Yu-Chen Chang, Tzu-Chen Yen & Chyong-Huey Lai

  3. Department of Nuclear Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan

    Tzu-Pei Su

  4. Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan

    Chun-Chieh Wang

  5. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, 5 Fu-Shin St., Gueishan Township, Taoyuan County, 33305, Taiwan

    Angel Chao, Hung-Hsueh Chou & Chyong-Huey Lai

  6. Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan

    Yu-Chen Chang

Authors
  1. Feng-Yuan Liu
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Correspondence to Chyong-Huey Lai.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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We obtained informed consents from all individual participants included in the study.

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Liu, FY., Su, TP., Wang, CC. et al. Roles of posttherapy 18F-FDG PET/CT in patients with advanced squamous cell carcinoma of the uterine cervix receiving concurrent chemoradiotherapy. Eur J Nucl Med Mol Imaging 45, 1197–1204 (2018). https://doi.org/10.1007/s00259-018-3957-8

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  • DOI: https://doi.org/10.1007/s00259-018-3957-8

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