caa a22 4500 445335645 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1634-2 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1634-2 Evaluation of 18F-FDG-PET for Early Detection of Suboptimal Response of Rectal Cancer to Preoperative Chemoradiotherapy: A Prospective Analysis [Elektronische Daten] [Tobias Leibold, Timothy Akhurst, David Chessin, Henry Yeung, Homer Macapinlac, Jinru Shia, Bruce Minsky, Leonard Saltz, Elyn Riedel, Madhu Mazumdar, Philip Paty, Martin Weiser, W. Wong, Steven Larson, José Guillem] Background: Early identification of inadequate response to preoperative chemoradiotherapy (CRT) may spare rectal cancer patients the toxicity of ineffective treatment. We prospectively evaluated tumor response with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) early in the course of preoperative CRT. Methods: A total of 27 prospectively accrued patients with locally advanced rectal cancer (T3-4/N1) received preoperative CRT (5040cGy+5FU-based chemotherapy). Patients underwent PET scanning before and 8-14days after commencement of CRT. Scans were interpreted using 3 standard parameters: SUVmax, SUVavg, and total lesion glycolysis (TLG) as well as an investigational parameter: visual response score (VRS). Percent pathologic response was quantified as a continuous variable. All PET parameters were correlated with pathology. Pathologic complete/near-complete response was defined as ≥95% tumor destruction, suboptimal response as <95%. Statistical analysis was performed using the Wilcoxon rank sum test and receiver operating characteristic (ROC) curve analysis. Results: Of the 27 patients, 11 (41%) had pathologic complete/near-complete response; 16 (59%) had suboptimal response. SUVmax, SUVavg, and TLG did not discriminate between responders and nonresponders. Visual response score (VRS) was statistically significantly higher for complete/near-complete responders than for suboptimal responders (65 vs. 33%, P=0.02). Suboptimal responders were identified with 94% sensitivity and 78% accuracy using a VRS cut-off of 50%. Conclusions: In this pilot study, FDG-PET at 8-14days after the beginning of preoperative CRT was unsuccessful at predicting pathological response with enough accuracy to justify an early change in therapy. Society of Surgical Oncology, 2011 Leibold Tobias Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Akhurst Timothy Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Chessin David Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Yeung Henry Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Macapinlac Homer Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Shia Jinru Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Minsky Bruce Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Saltz Leonard Department of Medicine (Gastrointestinal Oncology Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Riedel Elyn Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Mazumdar Madhu Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Paty Philip Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Weiser Martin Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Wong W. Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Larson Steven Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Guillem José Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2783-2789 1068-9265 18:10<2783 2011 18 10434 https://doi.org/10.1245/s10434-011-1634-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1634-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leibold Tobias Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Akhurst Timothy Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Chessin David Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Yeung Henry Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Macapinlac Homer Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Shia Jinru Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Minsky Bruce Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Saltz Leonard Department of Medicine (Gastrointestinal Oncology Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Riedel Elyn Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Mazumdar Madhu Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Paty Philip Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Weiser Martin Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Wong W. Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Larson Steven Department of Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Guillem José Department of Surgery (Colorectal Service), Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2783-2789 1068-9265 18:10<2783 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer