title: Association of post-treatment positron emission tomography with locoregional control and survival after radiation therapy for squamous cell carcinoma of the vulva.
abstract: The aim of this study was to investigate the use of post-treatment F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for vulvar cancer and compare metabolic response to clinical outcomes.
  
  
  
  This retrospective study included 21 patients with vulvar squamous cell carcinoma treated with curative-intent radiation between 2007 and 2015. All patients received intensity-modulated radiation treatment (IMRT), a pre-treatment FDG/PET-CT, and a post-treatment FDG-PET/CT performed at a median time of 3months post-IMRT.
  
  
  
  Median follow-up time was 28months. Post-treatment FDG-PET/CT demonstrated no evidence of disease (NED) in 12 patients and residual or progressive disease (PD) in 9. FDG-PET/CT response significantly correlated with biopsy-proven locoregional failure (p=0.02) and was the only significant factor associated with overall survival (OS) (p=0.049). Patients with NED on FDG-PET had a 2-year locoregional control (LRC) of 89% versus 25% for those with PD (p<0.01). Patients with NED on FDG-PET/CT had a 2-year OS of 100% versus 42% for those with PD (p=0.02). FDG-PET/CT evaluation had a sensitivity of 100% and a specificity of 71% for detecting pathologically proven residual disease in patients receiving neoadjuvant or definitive radiation.
  
  
  
  In this single-institution study of women with vulvar cancer, post-treatment response on FDG-PET/CT was associated with LRC and OS.
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, United States.
authors.forename: Yuan James
authors.initials: YJ
authors.lastname: Rao
authors.affiliation: University of Missouri - Kansas City School of Medicine, United States.
authors.forename: Comron
authors.initials: C
authors.lastname: Hassanzadeh
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, United States.
authors.forename: Anupama
authors.initials: A
authors.lastname: Chundury
authors.affiliation: Saint Louis University School of Medicine, United States.
authors.forename: Caressa
authors.initials: C
authors.lastname: Hui
authors.affiliation: Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, United States; Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Siegel
authors.affiliation: Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, United States; Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States.
authors.forename: Farrokh
authors.initials: F
authors.lastname: Dehdashti
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, United States.
authors.forename: Todd
authors.initials: T
authors.lastname: DeWees
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mullen
authors.affiliation: Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, United States.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.affiliation: Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, United States.
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, United States; Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Schwarz
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St. Louis, United States; Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, United States. Electronic address: pgrigsby@wustl.edu.
authors.forename: Perry W
authors.initials: PW
authors.lastname: Grigsby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012189:Retrospective Studies; D014846:Vulvar Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; Radiation; Squamous cell carcinoma; Vulvar cancer