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

  • Feng-Yuan Liu
  • Tzu-Pei Su
  • Chun-Chieh Wang
  • Angel Chao
  • Hung-Hsueh Chou
  • Yu-Chen Chang
  • Tzu-Chen Yen
  • Chyong-Huey Lai
Original Article



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.


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.


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).


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.


18F-FDG PET/CT Advanced cervical cancer Concurrent chemoradiotherapy Posttherapy surveillance Prognosis 



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

Compliance with ethical standards

Conflict of interest

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.

Informed consent

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


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Feng-Yuan Liu
    • 1
    • 2
  • Tzu-Pei Su
    • 3
  • Chun-Chieh Wang
    • 2
    • 4
  • Angel Chao
    • 2
    • 5
  • Hung-Hsueh Chou
    • 2
    • 5
  • Yu-Chen Chang
    • 1
    • 2
    • 6
  • Tzu-Chen Yen
    • 1
    • 2
  • Chyong-Huey Lai
    • 2
    • 5
  1. 1.Department of Nuclear Medicine and Molecular Imaging CenterChang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineTaoyuanTaiwan
  2. 2.Gynecologic Cancer Research CenterChang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineTaoyuanTaiwan
  3. 3.Department of Nuclear MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan
  4. 4.Department of Radiation OncologyChang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineTaoyuanTaiwan
  5. 5.Department of Obstetrics and GynecologyChang Gung Memorial Hospital at Linkou and Chang Gung University College of MedicineTaoyuan CountyTaiwan
  6. 6.Department of Medical Imaging and Radiological SciencesChang Gung UniversityTaoyuanTaiwan

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