Reduction of glucose metabolic activity is more accurate than change in size at predicting histopathologic response to neoadjuvant therapy in high-grade soft-tissue sarcomas

被引：145

作者：

Evilevitch, Vladimir ^{[2
]}

Weber, Wolfgang A. ^{[2
,9
]}

Tap, William D. ^{[3
,8
]}

Allen-Auerbach, Martin ^{[2
]}

Chow, Kira ^{[4
,8
]}

Nelson, Scott D. ^{[5
,8
]}

Eilber, Fredrick R. ^{[1
,8
]}

Eckardt, JefferyJ. ^{[6
,8
]}

Elashoff, Robert M. ^{[7
]}

Phelps, Michael E. ^{[2
]}

Czernin, Johannes ^{[2
]}

Eilber, Fritz C. ^{[1
,8
]}

机构：

[1] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Div Surg Oncol, Los Angeles, CA 90095 USA

[2] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Ahmanson Biol Imaging Div, Los Angeles, CA 90095 USA

[3] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Div Med Oncol, Los Angeles, CA 90095 USA

[4] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Dept Radiol, Los Angeles, CA 90095 USA

[5] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Dept Pathol, Los Angeles, CA 90095 USA

[6] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Div Orthoped Oncol, Los Angeles, CA 90095 USA

[7] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Dept Biostat, Los Angeles, CA 90095 USA

[8] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, UCLA Sarcoma Program, Los Angeles, CA 90095 USA

[9] Univ Freiburg, Abt Nukl Med, Fribourg, Switzerland

来源：

CLINICAL CANCER RESEARCH | 2008年 / 14卷 / 03期

关键词：

D O I：

10.1158/1078-0432.CCR-07-1762

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Change in tumor size as classified by Response Evaluation Criteria in Solid Tumors poorly correlates with histopathologic response to neoadjuvant therapy in patients with soft-tissue sarcomas. The aim of this study was to prospectively evaluate whether positron emission tomography with F-18-fluorodeoxyglucose (FDG-PET) allows for a more accurate evaluation of histopathologic response. Experimental Design: From January 2005 to January 2007, 42 patients with resectable biopsy-proven high-grade soft-tissue sarcoma underwent a FDG-PET/computed tomography scan before and after neoadjuvant treatment. Relative changes in tumor FDG uptake and size from the baseline to the follow-up scan were calculated, and their accuracy for assessment of histopathologic response was compared by receiver operating characteristic curve analysis. Histopathologic response was defined as >= 95% tumor necrosis. Results: In histopathologic responders (n = 8; 19%), reduction in tumor FDG uptake was significantly greater than in nonresponders (P < 0.001), whereas no significant differences were found for tumor size (P = 0.24). The area under the receiver operating characteristic curve for metabolic changes was 0.93, but only 0.60 for size changes (P = 0.004). Using a 60% decrease in tumor FDG uptake as a threshold resulted in a sensitivity of 100% and a specificity of 71% for assessment of histopathologic response, whereas Response Evaluation Criteria in Solid Tumors showed a sensitivity of 25% and a specificity of 100%. Conclusion: Quantitative FDG-PET was significantly more accurate than size-based criteria at assessing histopathologic response to neoadjuvant therapy. FDG-PET should be considered as a modality to monitor treatment response in patients with high-grade soft-tissue sarcoma.

引用

页码：715 / 720

页数：6

共 41 条

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