Re-irradiation in recurrent malignant glioma: prognostic value of [18F]FET-PET.
The aim of the present study is to determine new positron emission tomography (PET) imaging-related factors predictive of progression-free survival as well as survival in patients with recurrent malignant glioma (MG) prior to and after re-irradiation. Fifty-six patients with recurrent MG who underwent re-irradiation treatment and pretherapeutic dynamic [(18)F]-fluoroethyl-L-tyrosine (FET)-PET scan were retrospectively analyzed. The prognostic value of different parameters, such as biological tumor volume, maximal tumor uptake (SUV(max)/BG), mean tumor uptake (SUV(mean)/BG), as well as uptake kinetics, was evaluated. [(18)F]FET uptake kinetics was classified according to a five-point rating as category G(1-2) (strongly/mainly increasing kinetics), G(3) (mixed 1:1), or G(4-5) (mainly/strongly decreasing kinetics). Patients within the pretherapeutic kinetic group G(4-5) had significantly worse survival than the other two groups (p = 0.01). Multivariate analysis revealed that histologic grade, Karnofsky Performance Score (KPS), and kinetic group were independent significant predictors for survival after re-irradiation. The uptake kinetics of [(18)F]FET-PET is an independent determinant of overall and to a lesser extent also progression-free survival. Thus, [(18)F]FET-PET kinetics may provide valuable additional prognostic information for treatment decisions.
Department of Radiation Oncology, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany. maximilian.niyazi@med.uni-muenchen.de
Maximilian
M
Niyazi
Nathalie
N
Jansen
Ute
U
Ganswindt
Silke Birgit
SB
Schwarz
Julia
J
Geisler
Oliver
O
Schnell
Karen
K
Büsing
Sabina
S
Eigenbrod
Christian
C
la Fougère
Claus
C
Belka
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005910:Glioma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D014443:Tyrosine / Q000031:analogs & derivatives*; D055815:Young Adult
C117289:O-(2-fluoroethyl)tyrosine; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D014443:Tyrosine