Clinical and Translational Oncology

, Volume 18, Issue 2, pp 189–195 | Cite as

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

  • A. RaciborskaEmail author
  • K. Bilska
  • K. Drabko
  • E. Michalak
  • R. Chaber
  • M. Pogorzała
  • K. Połczyńska
  • G. Sobol
  • M. Wieczorek
  • K. Muszyńska-Rosłan
  • M. Rychlowska-Pruszyńska
  • C. Rodriguez-Galindo
  • M. Dziuk
Research Article



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).


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.


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.


Ewing sarcoma 18F-FDG PET Necrosis Chemotherapy 



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

Compliance with ethical standards

Conflict of interest

Nothing to declare.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2015

Authors and Affiliations

  • A. Raciborska
    • 1
    Email author
  • K. Bilska
    • 1
  • K. Drabko
    • 2
  • E. Michalak
    • 3
  • R. Chaber
    • 4
  • M. Pogorzała
    • 5
  • K. Połczyńska
    • 6
  • G. Sobol
    • 7
  • M. Wieczorek
    • 8
  • K. Muszyńska-Rosłan
    • 9
  • M. Rychlowska-Pruszyńska
    • 1
  • C. Rodriguez-Galindo
    • 10
  • M. Dziuk
    • 11
  1. 1.Department of Surgical Oncology for Children and YouthInstitute of Mother and ChildWarsawPoland
  2. 2.Department of Pediatric Hematology, Oncology and TransplantMedical University of LublinLublinPoland
  3. 3.Department of PathologyInstitute of Mother and ChildWarsawPoland
  4. 4.Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow TransplantationWroclaw Medical UniversityWroclawPoland
  5. 5.Department of Pediatric Hematology and Oncology Collegium MedicumNicolaus Copernicus UniversityBydgoszczPoland
  6. 6.Department of Pediatric Hematology and OncologyMedical University of GdanskGdanskPoland
  7. 7.Unit of Pediatric Oncology, Hematology and ChemotherapyMedical University of SilesiaKatowicePoland
  8. 8.Department of Pediatrics and OncologyPediatric and Oncological Children’s CentreChorzowPoland
  9. 9.Department of Pediatric Oncology and HematologyMedical University of Bialystok Children’s, Clinical Hospital of L. ZamenhofBialystokPoland
  10. 10.Pediatric Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders CenterHarvard Medical SchoolBostonUSA
  11. 11.Nuclear Medicine Department, Military Institute of Medicine, PET-CT DepartmentMazovian Medical CentreWarsawPoland

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