Comparison of PERCIST1.0 and RECIST1.1 for the evaluation of #br#
concurrent chemoradiotherapy response in advanced cervical cancer
XU Wei-na1, YU Li-juan2, YANG Zhi-guang1, XIN Jun1
1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China;
2. PET/CT-MR Center, Harbin Medical University Cancer Hospital, Harbin 150081, China
Abstract Objective: To compare 18F-FDG metabolism with morphologic criteria for evaluating concurrent chemoradiotherapy(CCRT) response of cervical cancer, and to analyze to relationship between treatment response and serum squamous cell carcinoma antigen(SCC-Ag) levels. Methods: From October 2011 to February 2016, twenty-two patients with primary advanced cervical cancer confirmed by pathology were enrolled in this retrospective study, with FIGO stage ⅡB～Ⅳ. 18F-FDG PET/CT was performed before and after CCRT and therapeutic response evaluation was performed according to both PERCIST1.0 and RECIST1.1. Pre- and post-treatment SCC-Ag levels were observed. Results: In PERCIST1.0 analysis, 3 cases had CMR, 9 cases had PMR, 7 cases had SMD, and 3 cases had PMD. In RECIST1.1 analysis, 11 cases had PR, 7 cases had SD, 4 cases had PD and no patient had CR. There was significant difference in response classification between the two criteria(χ2=16.76, P=0.01). There was 45.45%(10/22) disagreement found with a fair agreement(P=0.018). The therapeutic response rates(CMR/CR+PMR/PR) were 54.55%(12/22) and 50%(11/22), respectively. Of the 11 patients with PR by RECIST1.1 were classified to 2 CMR, 6 PMR and 3 SMD by PERCIST1.0. At same time, of the 7 cases with SD by RECIST1.1 were classified to 1 CMR, 3 PMR and 3 SMD by PERCIST1.0. The post-treatment SCC-Ag levels of different therapeutic response groups were significantly different(F=7.08, P=0.002), and there was positive correlated between them(γ=0.529, P=0.011). There was a significant difference between pre- and post-treatment SCC-Ag levels for therapeutic response group(T=2.28, P=0.044), while there was no significantly different for therapy no-response group(T=-0.42, P=0.687). Conclusion: Disagreement was found in CCRT therapeutic response of cervical cancer evaluation and PERCIST1.0 may be more accurately distinguish to therapeutic response.
XU Wei-na1,YU Li-juan2,YANG Zhi-guang1, et al. Comparison of PERCIST1.0 and RECIST1.1 for the evaluation of #br#
concurrent chemoradiotherapy response in advanced cervical cancer[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(10): 747-751.
[1]Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009[J]. CA Cancer J Clin, 2009, 59(4): 225-249.
[2]Monk BJ, Tewari KS, Koh WJ. Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions[J]. J Clin Oncol, 2007, 25(20): 2952-2965.
[3]Juweid ME, Cheson BD. Positron-emission tomography and assessment of cancer therapy[J]. N Engl J Med, 2006, 354(5): 496-507.
[4]Wahl RL, Jacene H, Kasamon Y, et al. From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors[J]. J Nucl Med, 2009, 50(Suppl): 122S-150S.
[5]Murakami A, Nakagawa T, Fukushima C, et al. Relationship between decreased expression of squamous cell carcinoma antigen 2 and E-cadherin in primary cervical cancer lesions and lymph node metastasis[J]. Oncol Rep, 2008, 19(1): 99-104.
[6]Ohno T, Nakayama Y, Nakamoto S. Measurement of serum squamouse cell carcinoma antigen levels as a predictor of radiation response in patients with carcinoma of the uterine cervix[J]. Cancer, 2003, 97(12): 3114-3120.
[7]Moule RN, Kayani L, Prior T, et al. Adaptive 18Fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography-based Target Volume Delineation in Radiotherapy Planning of Head and Neck Cancer[J]. Clin Oncol, 2011, 23(5): 364-371.
[8]Eisenhauer EA, Thearasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline(version1.1)[J]. Eur J Cancer, 2009, 45(2): 228-247.
[9]李亚明. 功能影像与肿瘤化疗疗效评价[J]. 中国实用内科杂志，2012，32（4）：243-244.
[10]Weber WA. Assessing tumor response to therapy[J]. J Nucl Med, 2009, 50(Suppl): 1s-10s.
[11]Min SJ, Jang HJ, Kim JH. Comparison of the RECIST and PERCIST criteria in solid tumors: a pooled analysis and review[J]. Oncotarget, 2016, 7(19): 27848-27854.
[12]Ding Q, Cheng X, Yang L, et al. PET/CT evaluation of response to chemotherapy in non-small cell lung cancer: PET response criteria in solid tumors(PERCIST) versus response evaluation criteria in solid tumors(RECIST)[J]. J Thorac Dis, 2014, 6(6): 677-683.
[13]Yanagawa M, Tatsumi M, Miyata H, et al. Evaluation of response to neoadjuvant chemotherapy for esophageal cancer: PET response criteria in solid tumors versus response evaluation criteria in solid tumors[J]. J Nucl Med, 2012, 53(6): 872-880.
[14]Skougaard K, Nielsen D, Jensen BV, et al. Comparison of EORTC criteria and PERCIST for PET/CT response evaluation of patients with metastatic colorectal cancer treated with irinotecan and cetuximab[J]. J Nucl Med, 2013, 54(7): 1026-1031.
[15]Ordu C, Selcuk NA, Akosman C, et al. Comparison of metabolic and anatomic response to chemotherapy based on PERCIST and RECIST in patients with advanced stage non-small cell lung cancer[J]. Asian Pac J Cancer Prev, 2015, 16(1): 321-326.
[16]Hu YY, Fan W, Zhang X, et al. Complementary Roles of Squamous Cell Carcinoma Antigen and (18)F-FDG PET/CT in Suspected Recurrence of Cervical Squamous Cell Cancer[J]. J Cancer, 2015, 20, 6(3): 287-291.
[17]Olsen JR, Dehdashti F, Siegel BA, et al. Prognostic utility of squamous cell carcinoma antigen in carcinoma of the cervix: association with pre- and post-treatment FDG-PET[J]. Int J Radiat Oncol Biol Phys, 2011, 81(3): 772-777.
[18]Schwarz JK, Siegel BA, Dehdashti F, et al. Association of posttherapy positron emission tomography with tumor response and survival in cervical carcinoma[J]. JAMA, 2007, 298(19): 2289-2295.
[19]Bhoil A, Singh B, Singh N, et al. Can 3’-deoxy-3’-(18)F-fluorothymidine or 2’-deoxy-2’-(18)F-fluoro-d-glucose PET/CT better assess response after 3-weeks treatment by epidermal growth factor receptor kinase inhibitor, in non-small lung cancer patients? Preliminary results[J]. Hell J Nucl Med, 2014, 17(2): 90-96.
[20]Grigsby PW. PET/CT imaging to guide cervical cancer therapy[J]. Future Oncol, 2009, 5(7): 953-958.
[21]Beriwal S, Kannan N, Sukumvanich P, et al. Complete metabolic response after definitive radiation therapy for cervical cancer: patterns and factors predicting for recurrence[J]. Gynecol Oncol, 2012, 127(2): 303-306.
[22]Keys HM, Bundy BN, Stehman FB, et al. Radiation therapy with and without extrafascial hysterectomy for bulky stage IB cervical carcinoma: a randomized trial of the Gynecologic Oncology Group[J]. Gynecol Oncol, 2003, 89(3): 343-353.
[23]Fendler WP, Philippe Tiega DB, Llhan H, et al. Validation of several SUV-based parameters derived from 18F-FDG PET for prediction of survival after SIRT of hepatic metastases from colorectal cancer[J]. J Nucl Med, 2013, 54(8): 1202-1208.
