Prognostic value of pretreatment (18)F-FDG PET-CT in radiotherapy for patients with hepatocellular carcinoma.
OBJECTIVE
The purpose of this study was to investigate the predictable value of pretreatment (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in radiotherapy (RT) for patients with hepatocellular carcinoma (HCC) or portal vein tumor thrombosis (PVTT).


METHODS
We conducted a retrospective analysis of 36 stage I-IV HCC patients treated with RT. (18)F-FDG PET-CT was performed before RT. Treatment target was determined HCC or PVTT lesions by treatment aim. They were irradiated at a median prescription dose of 50 Gy. The response was evaluated within 3 months after completion of RT using the Response Evaluation Criteria in Solid Tumors (RECIST). Response rate, overall survival (OS), and the pattern of failure (POF) were analyzed.


RESULTS
The response rate was 61.1%. The statistically significant prognostic factor affecting response in RT field was maximal standardized uptake value (maxSUV) only. The high SUV group (maxSUV ≥ 5.1) showed the better radiologic response than the low SUV group (maxSUV < 5.1). The median OS were 996.0 days in definitive group and 144.0 days in palliative group. Factors affecting OS were the %reduction of alpha-fetoprotein (AFP) level in the definitive group and Child-Pugh class in the palliative group. To predict the POF, maxSUV based on the cutoff value of 5.1 was the only significant factor in distant metastasis group.


CONCLUSIONS
The results of this study suggest that the maxSUV of (18)F-FDG PET-CT may be a prognostic factor for treatment outcome and the POF after RT. A %reduction of AFP level and Child-Pugh class could be used to predict OS in HCC.
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
In Young
IY
Jo
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Seok-Hyun
SH
Son
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Myungsoo
M
Kim
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Soo Yoon
SY
Sung
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Yong Kyun
YK
Won
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Hye Jin
HJ
Kang
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
So Jung
SJ
Lee
Department of Radiology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Yong-An
YA
Chung
Department of Radiology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Jin Kyoung
JK
Oh
Department of Radiation Oncology, the Catholic University of Korea College of Medicine, Seoul, Korea.
Chul-Seung
CS
Kay
Hepatocellular carcinoma; Positron emission tomography; Radiotherapy