Abstract
Purpose: To estimate the metabolic activity of rectal cancers at 6 and 12 weeks after completion of chemoradiation therapy (CRT) by 2-[fluorine-18] fluoro-2-deoxy-D-glucose-labeled positron emission tomography/computed tomography ([{sup 18}FDG]PET/CT) imaging and correlate with response to CRT. Methods and Materials: Patients with cT2-4N0-2M0 distal rectal adenocarcinoma treated with long-course neoadjuvant CRT (54 Gy, 5-fluouracil-based) were prospectively studied ( (ClinicalTrials.org) identifier (NCT00254683)). All patients underwent 3 PET/CT studies (at baseline and 6 and 12 weeks from CRT completion). Clinical assessment was at 12 weeks. Maximal standard uptake value (SUVmax) of the primary tumor was measured and recorded at each PET/CT study after 1 h (early) and 3 h (late) from {sup 18}FDG injection. Patients with an increase in early SUVmax between 6 and 12 weeks were considered 'bad' responders and the others as 'good' responders. Results: Ninety-one patients were included; 46 patients (51%) were 'bad' responders, whereas 45 (49%) patients were 'good' responders. 'Bad' responders were less likely to develop complete clinical response (6.5% vs. 37.8%, respectively; P=.001), less likely to develop significant histological tumor regression (complete or near-complete pathological response; 16% vs. 45%, respectively; P=.008) and exhibited greater final tumor dimension (4.3 cm vs. 3.3 cm; P=.03). Decrease between early (1
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Perez, Rodrigo O.;
[1]
Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)];
Habr-Gama, Angelita;
[2]
Sao Juliao, Guilherme P.;
[1]
Gama-Rodrigues, Joaquim;
[2]
Sousa, Afonso H.S.;
Campos, Fabio Guilherme;
Imperiale, Antonio R.;
[1]
Lynn, Patricio B.;
Proscurshim, Igor;
[2]
Nahas, Sergio Carlos;
[1]
Ono, Carla Rachel;
Buchpiguel, Carlos Alberto;
[3]
Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo (Brazil)]
- Department of Gastroenterology, Colorectal Surgery Division, University of Sao Paulo School of Medicine, Sao Paulo (Brazil)
- Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)
- Department of Radiology, Nuclear Medicine Division, University of Sao Paulo School of Medicine, Sao Paulo (Brazil)
Citation Formats
Perez, Rodrigo O., Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)], Habr-Gama, Angelita, Sao Juliao, Guilherme P., Gama-Rodrigues, Joaquim, Sousa, Afonso H.S., Campos, Fabio Guilherme, Imperiale, Antonio R., Lynn, Patricio B., Proscurshim, Igor, Nahas, Sergio Carlos, Ono, Carla Rachel, Buchpiguel, Carlos Alberto, and Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo (Brazil)].
Optimal Timing for Assessment of Tumor Response to Neoadjuvant Chemoradiation in Patients With Rectal Cancer: Do All Patients Benefit From Waiting Longer Than 6 Weeks?.
United States: N. p.,
2012.
Web.
doi:10.1016/J.IJROBP.2012.01.096.
Perez, Rodrigo O., Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)], Habr-Gama, Angelita, Sao Juliao, Guilherme P., Gama-Rodrigues, Joaquim, Sousa, Afonso H.S., Campos, Fabio Guilherme, Imperiale, Antonio R., Lynn, Patricio B., Proscurshim, Igor, Nahas, Sergio Carlos, Ono, Carla Rachel, Buchpiguel, Carlos Alberto, & Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo (Brazil)].
Optimal Timing for Assessment of Tumor Response to Neoadjuvant Chemoradiation in Patients With Rectal Cancer: Do All Patients Benefit From Waiting Longer Than 6 Weeks?.
United States.
https://doi.org/10.1016/J.IJROBP.2012.01.096
Perez, Rodrigo O., Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)], Habr-Gama, Angelita, Sao Juliao, Guilherme P., Gama-Rodrigues, Joaquim, Sousa, Afonso H.S., Campos, Fabio Guilherme, Imperiale, Antonio R., Lynn, Patricio B., Proscurshim, Igor, Nahas, Sergio Carlos, Ono, Carla Rachel, Buchpiguel, Carlos Alberto, and Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo (Brazil)].
2012.
"Optimal Timing for Assessment of Tumor Response to Neoadjuvant Chemoradiation in Patients With Rectal Cancer: Do All Patients Benefit From Waiting Longer Than 6 Weeks?"
United States.
https://doi.org/10.1016/J.IJROBP.2012.01.096.
@misc{etde_22149673,
title = {Optimal Timing for Assessment of Tumor Response to Neoadjuvant Chemoradiation in Patients With Rectal Cancer: Do All Patients Benefit From Waiting Longer Than 6 Weeks?}
author = {Perez, Rodrigo O., Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)], Habr-Gama, Angelita, Sao Juliao, Guilherme P., Gama-Rodrigues, Joaquim, Sousa, Afonso H.S., Campos, Fabio Guilherme, Imperiale, Antonio R., Lynn, Patricio B., Proscurshim, Igor, Nahas, Sergio Carlos, Ono, Carla Rachel, Buchpiguel, Carlos Alberto, and Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo (Brazil)]}
abstractNote = {Purpose: To estimate the metabolic activity of rectal cancers at 6 and 12 weeks after completion of chemoradiation therapy (CRT) by 2-[fluorine-18] fluoro-2-deoxy-D-glucose-labeled positron emission tomography/computed tomography ([{sup 18}FDG]PET/CT) imaging and correlate with response to CRT. Methods and Materials: Patients with cT2-4N0-2M0 distal rectal adenocarcinoma treated with long-course neoadjuvant CRT (54 Gy, 5-fluouracil-based) were prospectively studied ( (ClinicalTrials.org) identifier (NCT00254683)). All patients underwent 3 PET/CT studies (at baseline and 6 and 12 weeks from CRT completion). Clinical assessment was at 12 weeks. Maximal standard uptake value (SUVmax) of the primary tumor was measured and recorded at each PET/CT study after 1 h (early) and 3 h (late) from {sup 18}FDG injection. Patients with an increase in early SUVmax between 6 and 12 weeks were considered 'bad' responders and the others as 'good' responders. Results: Ninety-one patients were included; 46 patients (51%) were 'bad' responders, whereas 45 (49%) patients were 'good' responders. 'Bad' responders were less likely to develop complete clinical response (6.5% vs. 37.8%, respectively; P=.001), less likely to develop significant histological tumor regression (complete or near-complete pathological response; 16% vs. 45%, respectively; P=.008) and exhibited greater final tumor dimension (4.3 cm vs. 3.3 cm; P=.03). Decrease between early (1 h) and late (3 h) SUVmax at 6-week PET/CT was a significant predictor of 'good' response (accuracy of 67%). Conclusions: Patients who developed an increase in SUVmax after 6 weeks were less likely to develop significant tumor downstaging. Early-late SUVmax variation at 6-week PET/CT may help identify these patients and allow tailored selection of CRT-surgery intervals for individual patients.}
doi = {10.1016/J.IJROBP.2012.01.096}
journal = []
issue = {5}
volume = {84}
journal type = {AC}
place = {United States}
year = {2012}
month = {Dec}
}
title = {Optimal Timing for Assessment of Tumor Response to Neoadjuvant Chemoradiation in Patients With Rectal Cancer: Do All Patients Benefit From Waiting Longer Than 6 Weeks?}
author = {Perez, Rodrigo O., Angelita and Joaquim Gama Institute, Sao Paulo (Brazil)], Habr-Gama, Angelita, Sao Juliao, Guilherme P., Gama-Rodrigues, Joaquim, Sousa, Afonso H.S., Campos, Fabio Guilherme, Imperiale, Antonio R., Lynn, Patricio B., Proscurshim, Igor, Nahas, Sergio Carlos, Ono, Carla Rachel, Buchpiguel, Carlos Alberto, and Department of Radiology and Nuclear Medicine, Hospital do Coracao, Sao Paulo (Brazil)]}
abstractNote = {Purpose: To estimate the metabolic activity of rectal cancers at 6 and 12 weeks after completion of chemoradiation therapy (CRT) by 2-[fluorine-18] fluoro-2-deoxy-D-glucose-labeled positron emission tomography/computed tomography ([{sup 18}FDG]PET/CT) imaging and correlate with response to CRT. Methods and Materials: Patients with cT2-4N0-2M0 distal rectal adenocarcinoma treated with long-course neoadjuvant CRT (54 Gy, 5-fluouracil-based) were prospectively studied ( (ClinicalTrials.org) identifier (NCT00254683)). All patients underwent 3 PET/CT studies (at baseline and 6 and 12 weeks from CRT completion). Clinical assessment was at 12 weeks. Maximal standard uptake value (SUVmax) of the primary tumor was measured and recorded at each PET/CT study after 1 h (early) and 3 h (late) from {sup 18}FDG injection. Patients with an increase in early SUVmax between 6 and 12 weeks were considered 'bad' responders and the others as 'good' responders. Results: Ninety-one patients were included; 46 patients (51%) were 'bad' responders, whereas 45 (49%) patients were 'good' responders. 'Bad' responders were less likely to develop complete clinical response (6.5% vs. 37.8%, respectively; P=.001), less likely to develop significant histological tumor regression (complete or near-complete pathological response; 16% vs. 45%, respectively; P=.008) and exhibited greater final tumor dimension (4.3 cm vs. 3.3 cm; P=.03). Decrease between early (1 h) and late (3 h) SUVmax at 6-week PET/CT was a significant predictor of 'good' response (accuracy of 67%). Conclusions: Patients who developed an increase in SUVmax after 6 weeks were less likely to develop significant tumor downstaging. Early-late SUVmax variation at 6-week PET/CT may help identify these patients and allow tailored selection of CRT-surgery intervals for individual patients.}
doi = {10.1016/J.IJROBP.2012.01.096}
journal = []
issue = {5}
volume = {84}
journal type = {AC}
place = {United States}
year = {2012}
month = {Dec}
}