title: Fluorodeoxyglucose Uptake on Positron Emission Tomography Is a Useful Predictor of Long-Term Pain Control After Palliative Radiation Therapy in Patients With Painful Bone Metastases: Results of a Single-Institute Prospective Study.
abstract: OBJECTIVE
  To determine whether fluorodeoxyglucose positron emission tomography (FDG-PET) before and after palliative radiation therapy (RT) can predict long-term pain control in patients with painful bone metastases.
  
  
  METHODS
  Thirty-one patients with bone metastases who received RT were prospectively included. Forty painful metastatic treatment fields were evaluated. All patients had undergone pre-RT and post-RT PET/CT scanning. We evaluated the relationships between the pre-RT, post-RT, and changes in maximum standardized uptake value (SUVmax) and the pain response, and between SUVmax and pain relapse of the bone metastases in the treatment field. In addition, we compared the SUVmax according to the length of time from the completion of RT to pain relapse of the bone metastases.
  
  
  RESULTS
  Regarding the pain response at 4 weeks after the completion of RT, there were 36 lesions of 27 patients in the responder group and 4 lesions of 4 patients in the nonresponder group. Changes in the SUVmax differed significantly between the responder and nonresponder groups in both the early and delayed phases (P=.0292 and P=.0139, respectively), but no relationship was observed between the pre-RT and post-RT SUVmax relative to the pain response. The responder group was evaluated for the rate of relapse. Thirty-five lesions of 26 patients in the responder group were evaluated, because 1 patient died of acute renal failure at 2 months after RT. Twelve lesions (34%) showed pain relapse, and 23 lesions (66%) did not. There were significant differences between the relapse and nonrelapse patients in terms of the pre-RT (early/delayed phases: P<.0001/P<.0001), post-RT (P=.0199/P=.0261), and changes in SUVmax (P=.0004/P=.004).
  
  
  CONCLUSIONS
  FDG-PET may help predict the outcome of pain control in the treatment field after palliative RT for painful bone metastases.
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan. Electronic address: taka.t-may7@med.Tottori-u.ac.jp.
authors: Takatoshi
authors: T
authors: Tahara
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
authors: Shinya
authors: S
authors: Fujii
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
authors: Toshihide
authors: T
authors: Ogawa
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
authors: Koichi
authors: K
authors: Michimoto
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
authors: Takeru
authors: T
authors: Fukunaga
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
authors: Tomohiko
authors: T
authors: Tanino
authors: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
authors: Nobue
authors: N
authors: Uchida
authors: Division of Radiology, Tottori Municipal Hospital, Tottori, Japan.
authors: Tsutomu
authors: T
authors: Matsuki
authors: Division of Radiology, Tottori Municipal Hospital, Tottori, Japan.
authors: Hiroaki
authors: H
authors: Sakamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications / Q000378:metabolism / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D005266:Femoral Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000556:secondary; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010166:Palliative Care / Q000379:methods*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012008:Recurrence; D012044:Regression Analysis; D013125:Spinal Neoplasms / Q000150:complications / Q000378:metabolism / Q000532:radiotherapy / Q000556:secondary; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18