Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Refereed |
Title | Metabolic response assessment with 18F-FDG-PET/CT is superior to modified RECIST for the evaluation of response to platinum-based doublet chemotherapy in malignant pleural mesothelioma. |
Journal | Formal name:European journal of radiology Abbreviation:Eur J Radiol ISSN code:1872-7727(Electronic)0720-048X(Linking) |
Domestic / Foregin | Foregin |
Volume, Number, Page | 86,pp.92-98 |
Papers・Author | Kanemura Shingo, Kuribayashi Kozo, Funaguchi Norihiko, Shibata Eisuke, Mikami Koji, Doi Hiroshi, Kitajima Kazuhiro, Hasegawa Seiki, Nakano Takashi |
Publication date | 2017/01 |
Papers・Description | PURPOSE:Efficient monitoring of tumor responsiveness to chemotherapy is essential to mitigate high mortality risks and cytotoxic effects of chemotherapeutics. However, there is no consensus on the most suitable diagnostic technique/parameters for assessing response to chemotherapy in malignant pleural mesothelioma (MPM). We compared the tumor responsiveness of MPM patientsas assessed using modified RECIST (mRECIST) criteria and integrated 18F-FDG-PET/CT.METHODS:Histologically confirmed MPM patients (N=82) who were treated with three cycles of cisplatin and pemetrexed, or carboplatin and pemetrexed, were included. mRECIST and integrated 18F-FDG-PET/CT were used to evaluate MPM tumor response to chemotherapy. Metabolic non-responders were defined as those with a 25% or greater increase in SUVmax compared with the previous value. Time to progression (TTP) and overall survival (OS) were compared between metabolic-responders and non-responders.RESULTS:After three cycles of chemotherapy, 62(75.6%) of the patients were classified as having SD, 15 (18%) with partial remission (PR), and 5 (6%) with progressive disease (PD), based on mRECIST criteria. The cumulative median OS was 728.0days (95% confidence interval [CI]: 545.9-910.1) and cumulative median TTP was 365.0days (95% CI: 296.9-433.1). For the 82 patients, the disease control rate was 93.9%, whereas the metabolic response rate was only 71.9% (p<0.001). All PD and PR patients were found to be metabolic responders on 18F-FDG-PET/CT; however, among the 62mRECIST SD patients, 18 (29%) were classified as metabolic non-responders. The median TTP for metabolic responders was 13.7 months, while it was 10.0 months for non-responders(p<0.001). Metabolic responders had a trend toward longer OS, although the difference did not reach statistical significance (metabolic responders:33.9 months; non-responders: 21.6 months; p>0.05).CONCLUSION:Several mRECIST-confirmed SD MPM patients may be classified as metabolic non-responders on1 |
DOI | 10.1016/j.ejrad.2016.11.009 |
PMID | 28027772 |