title: Predicting outcome in patients with rhabdomyosarcoma: role of [(18)f]fluorodeoxyglucose positron emission tomography.
abstract: OBJECTIVE
  To evaluate whether [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) response of the primary tumor after induction chemotherapy predicts outcomes in rhabdomyosarcoma (RMS).
  
  
  METHODS
  After excluding those with initial tumor resection, 107 patients who underwent FDG-PET after induction chemotherapy at Memorial Sloan Kettering Cancer Center from 2002 to 2013 were reviewed. Local control (LC), progression-free survival (PFS), and overall survival (OS) were calculated according to FDG-PET response and maximum standardized uptake value (SUV) at baseline (PET1/SUV1), after induction chemotherapy (PET2/SUV2), and after local therapy (PET3/SUV3). Receiver operator characteristic curves were used to determine the optimal cutoff for dichotomization of SUV1 and SUV2 values.
  
  
  RESULTS
  The SUV1 (<9.5 vs ≥9.5) was predictive of PFS (P=.02) and OS (P=.02), but not LC. After 12 weeks (median) of induction chemotherapy, 45 patients had negative PET2 scans and 62 had positive scans: 3-year PFS was 72% versus 44%, respectively (P=.01). The SUV2 (<1.5 vs ≥1.5) was similarly predictive of PFS (P=.005) and was associated with LC (P=.02) and OS (P=.03). A positive PET3 scan was predictive of worse PFS (P=.0009), LC (P=.05), and OS (P=.03).
  
  
  CONCLUSIONS
  [(18)F]fluorodeoxyglucose positron emission tomography is an early indicator of outcomes in patients with RMS. Future prospective trials may incorporate FDG-PET response data for risk-adapted therapy and early assessment of new treatment regimens.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Dana L
authors.initials: DL
authors.lastname: Casey
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Wexler
authors.affiliation: Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Josef J
authors.initials: JJ
authors.lastname: Fox
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Kavita V
authors.initials: KV
authors.lastname: Dharmarajan
authors.affiliation: Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Heiko
authors.initials: H
authors.lastname: Schoder
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Alison N
authors.initials: AN
authors.lastname: Price
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: woldens@mskcc.org.
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Wolden
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D018232:Rhabdomyosarcoma, Alveolar / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018233:Rhabdomyosarcoma, Embryonal / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18