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Response to chemotherapy estimates by FDG PET is an important prognostic factor in patients with Ewing sarcoma

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Abstract

Background

Response to chemotherapy is a prognostic factor in patients with Ewing sarcoma (ES); the role of FDG PET to predict response in these patients has not been thoroughly investigated. We evaluated the diagnostic accuracy and the potential of FDG PET to predict response to chemotherapy (CHT).

Materials and methods

We analyzed data of 50 patients with ES (median age 12.6 years). All patients were treated with neoadjuvant CHT, and underwent surgery for local control. All patients had 18F-FDG PET/CT at diagnosis and after induction CHT, prior to local control. We compared response assessed by histopathology with FDG PET using standard uptake values (SUVs).

Results

Median SUV at diagnosis (SUV I) was 5 (range 1.2–17), and median SUV after neoadjuvant chemotherapy (SUV II) was 1.8 (range 0–8.4). Median SUV II/I ratio was 0.3 (range 0–1). SUV at diagnosis was significantly lower in patients with good histological response than in patients with poor histological response (median 3.8 vs. 7.2, p 0.02). We found a significant correlation between SUV II and outcome; the positive predictive value of an SUV II ≤ 2.5 for favorable response was 84.21 %, and the median SUV II was significantly higher in patients with disease progression (2.3 vs. 1.6, p = 0.04). In multivariate analysis, necrosis and SUV II were significant predictors of outcome.

Conclusions

18F-FDG PET demonstrates high diagnostic accuracy for response to initial chemotherapy in patients with ES and it correlates with outcome. The role of FDG PET in predicting response and outcome should be further investigated.

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Acknowledgments

Special thanks to the Children’s Medical Care Foundation, and Mr Bjoern Martinoff, President for the international support.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Ul. Kasprzaka 17a, 01-211, Warsaw, Poland

    A. Raciborska, K. Bilska & M. Rychlowska-Pruszyńska

  2. Department of Pediatric Hematology, Oncology and Transplant, Medical University of Lublin, Lublin, Poland

    K. Drabko

  3. Department of Pathology, Institute of Mother and Child, Warsaw, Poland

    E. Michalak

  4. Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland

    R. Chaber

  5. Department of Pediatric Hematology and Oncology Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

    M. Pogorzała

  6. Department of Pediatric Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland

    K. Połczyńska

  7. Unit of Pediatric Oncology, Hematology and Chemotherapy, Medical University of Silesia, Katowice, Poland

    G. Sobol

  8. Department of Pediatrics and Oncology, Pediatric and Oncological Children’s Centre, Chorzow, Poland

    M. Wieczorek

  9. Department of Pediatric Oncology and Hematology, Medical University of Bialystok Children’s, Clinical Hospital of L. Zamenhof, Bialystok, Poland

    K. Muszyńska-Rosłan

  10. Pediatric Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA

    C. Rodriguez-Galindo

  11. Nuclear Medicine Department, Military Institute of Medicine, PET-CT Department, Mazovian Medical Centre, Warsaw, Poland

    M. Dziuk

Authors
  1. A. Raciborska
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  2. K. Bilska
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  3. K. Drabko
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  5. R. Chaber
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  6. M. Pogorzała
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  7. K. Połczyńska
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  8. G. Sobol
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  13. M. Dziuk
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Correspondence to A. Raciborska.

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Raciborska, A., Bilska, K., Drabko, K. et al. Response to chemotherapy estimates by FDG PET is an important prognostic factor in patients with Ewing sarcoma. Clin Transl Oncol 18, 189–195 (2016). https://doi.org/10.1007/s12094-015-1351-6

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  • DOI: https://doi.org/10.1007/s12094-015-1351-6

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