Is the standardized uptake value of FDG-PET/CT predictive of pathological complete response in locally advanced rectal cancer treated with capecitabine-based neoadjuvant chemoradiation?

Chiara Bampo, Alessandra Alessi, Simona Fantini, Gaia Bertarelli, Filippo De Braud, Emilio Bombardieri, Francesca Valvo, Flavio Crippa, Maria Di Bartolomeo, Luigi Mariani, Massimo Milione, Pamela Biondani, Barbara Avuzzi, Chiara Chiruzzi, Filippo Pietrantonio

Research output: Contribution to journalArticle

Abstract

Objectives: Our aim was to assess FDG-PET/CT as a surrogate biomarker of the pathological complete response in locally advanced rectal cancer treated with neoadjuvant chemoradiation. Methods: T3-4 and/or N+ rectal cancer patients were treated prospectively with capecitabine-based chemoradiation and total mesorectal excision 7-8 weeks later. FDG-PET/CT uptake was obtained at baseline, after 2 weeks, and 6 weeks following treatment completion, calculating the maximum standardized uptake value (SUV) and percentage difference to identify the early and late metabolic 'response index'. Results: Thirty-one patients were treated from January 2009 to January 2012 at the Istituto Nazionale dei Tumori of Milan. One patient was excluded due to surgery refusal. The pathological complete response rate was 30%. Early FDG-PET/CT was performed in 24 consenting patients and failed to show predictive utility. On the contrary, significant differences in late SUV value and response index were observed between complete and noncomplete pathological responders (p = 0.0006 and 0.03). In multivariate analysis including most relevant SUV parameters, none of them was independently associated with a pathological complete response. With receiver operating characteristic curve analysis, a late SUV threshold

Original languageEnglish
Pages (from-to)191-199
Number of pages9
JournalOncology
Volume84
Issue number4
DOIs
Publication statusPublished - Mar 2013

Keywords

  • Capecitabine
  • Complete response
  • Pathology
  • PET
  • Predictive factor
  • Radiochemotherapy
  • Rectal cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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