TY - JOUR
T1 - O PET/CT interim com fluoreto- 18 F é capaz de predizer desfechos após a terapia com rádio-223?
AU - Etchebehere, Elba
AU - Brito, Ana Emília
AU - Kairemo, Kalevi
AU - Rohren, Eric
AU - Araujo, John
AU - Macapinlac, Homer
N1 - Funding Information:
This work received funding from the James E. Anderson Distinguished Professorship Endowment and from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, São Paulo Research Foundation).
Publisher Copyright:
© Colégio Brasileiro de Radiologia e Diagnóstico por Imagem.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective: To determine whether an interim 18 F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride ( 223 RaCl 2 ) therapy is able to identify patients that will not respond to treatment. Materials and Methods: We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to 223 RaCl 2 therapy. All of the patients underwent baseline and interim 18 F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of 223 RaCl 2 . The skeletal tumor burden—expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF 10 )—was calculated for the baseline and the interim studies. The percent change in TLF 10 between the baseline and interim studies (%TFL 10 ) was calculated as follows: %TFL 10 = interim TLF 10 − baseline TLF 10 / baseline TLF 10 . End points were overall survival, progression-free survival, and skeletal-related events. Results: The mean age of the patients was 72.4 ± 10.2 years (range, 43.3–88.8 years). The %TLF 10 was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236–2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557–2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399–6.312). Conclusion: The skeletal tumor burden on an interim 18 F-fluoride PET/CT, performed after three cycles of 223 RaCl 2 , is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time.
AB - Objective: To determine whether an interim 18 F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride ( 223 RaCl 2 ) therapy is able to identify patients that will not respond to treatment. Materials and Methods: We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to 223 RaCl 2 therapy. All of the patients underwent baseline and interim 18 F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of 223 RaCl 2 . The skeletal tumor burden—expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF 10 )—was calculated for the baseline and the interim studies. The percent change in TLF 10 between the baseline and interim studies (%TFL 10 ) was calculated as follows: %TFL 10 = interim TLF 10 − baseline TLF 10 / baseline TLF 10 . End points were overall survival, progression-free survival, and skeletal-related events. Results: The mean age of the patients was 72.4 ± 10.2 years (range, 43.3–88.8 years). The %TLF 10 was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236–2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557–2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399–6.312). Conclusion: The skeletal tumor burden on an interim 18 F-fluoride PET/CT, performed after three cycles of 223 RaCl 2 , is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time.
KW - Bone neoplasms/diagnostic imaging
KW - Positron-emission tomography/methods
KW - Prostatic neoplasms
KW - Radium-223
KW - Sodium fluoride
KW - Tomography,X-ray computed/methods
KW - Tumor burden
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U2 - 10.1590/0100-3984.2017.0178
DO - 10.1590/0100-3984.2017.0178
M3 - Article
AN - SCOPUS:85063542444
SN - 0100-3984
VL - 52
SP - 33
EP - 40
JO - Radiologia Brasileira
JF - Radiologia Brasileira
IS - 1
ER -