Andrea Angelo Martoni , Marta Rosati , Claudio Zamagni , Pierandrea De Jaco , Paolo Castellucci , Sara Quercia , Alessandra Bernardi , Stefano Fanti
{"title":"FDG-PET-CT对晚期卵巢癌新辅助化疗早期完全代谢反应预测及预后价值的探索性研究","authors":"Andrea Angelo Martoni , Marta Rosati , Claudio Zamagni , Pierandrea De Jaco , Paolo Castellucci , Sara Quercia , Alessandra Bernardi , Stefano Fanti","doi":"10.1016/j.cogc.2012.04.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Aim</h3><p>Early complete metabolic response (e-CMR) by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) during neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (AOC) could have predictive and prognostic value. The present explorative study prospectively investigated changes of dual-time FDG-PET, at baseline and after 3 cycles of NACT in patients who were not candidates for upfront debulking surgery by comparing with standard serum cancer antigen 125 (CA-125) monitoring.</p></div><div><h3>Patients and Methods</h3><p>Fifty consecutive patients with AOC were treated with 6 cycles of carboplatin/paclitaxel before surgery. FDG-PET and serum CA-125 were evaluated at baseline and after 3 cycles. e-CMR and early complete biochemical response (e-CBR) were defined as the normalization of the maximum standardized uptake values and serum CA-125 levels, respectively.</p></div><div><h3>Results</h3><p>e-CMR and e-CBR were observed in 34% and 38% of patients, respectively. At the end of NACT, an optimal pathologic response (pR) and optimal surgery with no residual tumor (R0) were achieved in 23 (46%) and 26 (52%) patients, respectively. E-CMR and e-CBR positive predictive value was 88% and 84% for pR and 88% and 89% for R0, respectively. After a median follow-up of 42 months, 41 (82%) patients had progressed and 32 (64%) died. Median progression-free survival and overall survival were 13.8 and 28.1 months, respectively. At multivariate analysis, e-CMR, but not e-CBR, showed an independent prognostic value with regard to both progression-free survival and overall survival.</p></div><div><h3>Conclusions</h3><p>e-CMR may predict pR and R0 surgery obtained at the end of NACT and identify patients a favorable long-term outcome.</p></div>","PeriodicalId":100274,"journal":{"name":"Clinical Ovarian and Other Gynecologic Cancer","volume":"5 1","pages":"Pages 2-9"},"PeriodicalIF":0.0000,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cogc.2012.04.003","citationCount":"3","resultStr":"{\"title\":\"Explorative Study on the Predictive and Prognostic Value of Early Complete Metabolic Response By FDG-PET–CT During Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer\",\"authors\":\"Andrea Angelo Martoni , Marta Rosati , Claudio Zamagni , Pierandrea De Jaco , Paolo Castellucci , Sara Quercia , Alessandra Bernardi , Stefano Fanti\",\"doi\":\"10.1016/j.cogc.2012.04.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Aim</h3><p>Early complete metabolic response (e-CMR) by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) during neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (AOC) could have predictive and prognostic value. The present explorative study prospectively investigated changes of dual-time FDG-PET, at baseline and after 3 cycles of NACT in patients who were not candidates for upfront debulking surgery by comparing with standard serum cancer antigen 125 (CA-125) monitoring.</p></div><div><h3>Patients and Methods</h3><p>Fifty consecutive patients with AOC were treated with 6 cycles of carboplatin/paclitaxel before surgery. FDG-PET and serum CA-125 were evaluated at baseline and after 3 cycles. e-CMR and early complete biochemical response (e-CBR) were defined as the normalization of the maximum standardized uptake values and serum CA-125 levels, respectively.</p></div><div><h3>Results</h3><p>e-CMR and e-CBR were observed in 34% and 38% of patients, respectively. At the end of NACT, an optimal pathologic response (pR) and optimal surgery with no residual tumor (R0) were achieved in 23 (46%) and 26 (52%) patients, respectively. E-CMR and e-CBR positive predictive value was 88% and 84% for pR and 88% and 89% for R0, respectively. After a median follow-up of 42 months, 41 (82%) patients had progressed and 32 (64%) died. Median progression-free survival and overall survival were 13.8 and 28.1 months, respectively. At multivariate analysis, e-CMR, but not e-CBR, showed an independent prognostic value with regard to both progression-free survival and overall survival.</p></div><div><h3>Conclusions</h3><p>e-CMR may predict pR and R0 surgery obtained at the end of NACT and identify patients a favorable long-term outcome.</p></div>\",\"PeriodicalId\":100274,\"journal\":{\"name\":\"Clinical Ovarian and Other Gynecologic Cancer\",\"volume\":\"5 1\",\"pages\":\"Pages 2-9\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2012-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.cogc.2012.04.003\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Ovarian and Other Gynecologic Cancer\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212955312000415\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Ovarian and Other Gynecologic Cancer","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212955312000415","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Explorative Study on the Predictive and Prognostic Value of Early Complete Metabolic Response By FDG-PET–CT During Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer
Background and Aim
Early complete metabolic response (e-CMR) by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) during neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (AOC) could have predictive and prognostic value. The present explorative study prospectively investigated changes of dual-time FDG-PET, at baseline and after 3 cycles of NACT in patients who were not candidates for upfront debulking surgery by comparing with standard serum cancer antigen 125 (CA-125) monitoring.
Patients and Methods
Fifty consecutive patients with AOC were treated with 6 cycles of carboplatin/paclitaxel before surgery. FDG-PET and serum CA-125 were evaluated at baseline and after 3 cycles. e-CMR and early complete biochemical response (e-CBR) were defined as the normalization of the maximum standardized uptake values and serum CA-125 levels, respectively.
Results
e-CMR and e-CBR were observed in 34% and 38% of patients, respectively. At the end of NACT, an optimal pathologic response (pR) and optimal surgery with no residual tumor (R0) were achieved in 23 (46%) and 26 (52%) patients, respectively. E-CMR and e-CBR positive predictive value was 88% and 84% for pR and 88% and 89% for R0, respectively. After a median follow-up of 42 months, 41 (82%) patients had progressed and 32 (64%) died. Median progression-free survival and overall survival were 13.8 and 28.1 months, respectively. At multivariate analysis, e-CMR, but not e-CBR, showed an independent prognostic value with regard to both progression-free survival and overall survival.
Conclusions
e-CMR may predict pR and R0 surgery obtained at the end of NACT and identify patients a favorable long-term outcome.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
