Predicting Outcome in Patients with Rhabdomyosarcoma: Role of [{sup 18}F]Fluorodeoxyglucose Positron Emission Tomography

Journal Article · Mon Dec 01 04:00:00 EST 2014 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2014.08.005· OSTI ID:22420506

Casey, Dana L. ^[1]; Wexler, Leonard H. ^[2]; Fox, Josef J. ^[3]; Dharmarajan, Kavita V. ^[1]; Schoder, Heiko ^[3]; Price, Alison N. ^[2]

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1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States)
2. Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York (United States)
3. Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (United States)

Purpose: To evaluate whether [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) response of the primary tumor after induction chemotherapy predicts outcomes in rhabdomyosarcoma (RMS). Methods and Materials: After excluding those with initial tumor resection, 107 patients who underwent FDG-PET after induction chemotherapy at Memorial Sloan Kettering Cancer Center from 2002 to 2013 were reviewed. Local control (LC), progression-free survival (PFS), and overall survival (OS) were calculated according to FDG-PET response and maximum standardized uptake value (SUV) at baseline (PET1/SUV1), after induction chemotherapy (PET2/SUV2), and after local therapy (PET3/SUV3). Receiver operator characteristic curves were used to determine the optimal cutoff for dichotomization of SUV1 and SUV2 values. Results: The SUV1 (<9.5 vs ≥9.5) was predictive of PFS (P=.02) and OS (P=.02), but not LC. After 12 weeks (median) of induction chemotherapy, 45 patients had negative PET2 scans and 62 had positive scans: 3-year PFS was 72% versus 44%, respectively (P=.01). The SUV2 (<1.5 vs ≥1.5) was similarly predictive of PFS (P=.005) and was associated with LC (P=.02) and OS (P=.03). A positive PET3 scan was predictive of worse PFS (P=.0009), LC (P=.05), and OS (P=.03). Conclusions: [{sup 18}F]fluorodeoxyglucose positron emission tomography is an early indicator of outcomes in patients with RMS. Future prospective trials may incorporate FDG-PET response data for risk-adapted therapy and early assessment of new treatment regimens.

• OSTI ID: 22420506
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 90; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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