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Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?

  • Marie VoglimacciEmail author
  • Erwan Gabiache
  • Amélie Lusque
  • Gwenaël Ferron
  • Anne Ducassou
  • Denis Querleu
  • Stéphanie Motton
  • Elodie Chantalat
  • Frédéric Courbon
  • Alejandra Martinez
Original Article
  • 28 Downloads

Abstract

Purpose

Aim of the study was to assess impact of pretherapeutic FDG-PET/CT metabolic parameters on response to chemoradiotherapy (CRT) and survival in locally advanced cervical cancer (LACC) patients without paraaortic lymph node involvement.

Methods

LACC patients treated with CRT without macrometastatic involvement after paraaortic surgical staging were included. All patients had received at least 45 Gy radiotherapy and five cycles of platinum-based chemotherapy. High-risk histologies were excluded. Two senior nuclear physician experts in gynaecologic oncology reviewed all PET/CT exams, and extracted tumor SUVmax, MTV, and TLG (standardized uptake value, metabolic tumor volume, and total lesion glycolysis respectively). Response to CRT was assessed with a pelvic MRI done after 45 Gy. Medical charts were reviewed for clinical, pathology, and survival data.

Results

Ninety-three patients were included in the study. The overall survival (OS) rates at 2 and 5 years were 83.0% [95%CI: 72.5–89.8] and 71.2% [57.5–81.2] respectively. The RFS rates at 2 and 5 years were 72.5% [61.5–80.9] and 64.4% [52.3–74.2] respectively. Higher cervical SUVmax and TLG were significantly associated with poor response to CRT. In multivariate analysis, cervical SUVmax was the main predictive factor for OS.

Conclusion

Cervical tumor SUVmax was demonstrated to be a non-invasive prognostic biomarker for response to treatment and survival in LACC patients without paraaortic involvement. SUVmax and other PET/CT metabolic parameters require further prospective investigation to help tailoring of local treatment.

Keywords

Cervix cancer SUV Prognosis Chemoradiotherapy FDG-PET/CT 

Notes

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors of this article have no relevant relationships that could be perceived as a real or apparent conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Marie Voglimacci
    • 1
    Email author
  • Erwan Gabiache
    • 2
  • Amélie Lusque
    • 3
  • Gwenaël Ferron
    • 1
  • Anne Ducassou
    • 4
  • Denis Querleu
    • 5
  • Stéphanie Motton
    • 1
  • Elodie Chantalat
    • 1
  • Frédéric Courbon
    • 2
  • Alejandra Martinez
    • 1
  1. 1.Department of Surgical OncologyIUCT-OncopoleToulouse Cedex 9France
  2. 2.Department of Nuclear MedicineIUCT-OncopoleToulouseFrance
  3. 3.Department of BiostatisticsIUCT-OncopoleToulouseFrance
  4. 4.Department of RadiotherapyIUCT-OncopoleToulouseFrance
  5. 5.Department of Surgical OncologyInstitut BergoniéBordeauxFrance

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