TY - JOUR
T1 - The role of [18F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer
T2 - Experience of the European Institute of Oncology, Milan, Italy
AU - Lazzari, Roberta
AU - Cecconi, Agnese
AU - Jereczek-Fossa, Barbara A.
AU - Travaini, Laura Lavinia
AU - Dell'Acqua, Veronica
AU - Cattani, Federica
AU - Rizzo, Stefania
AU - Fodor, Cristiana
AU - Landoni, Fabio
AU - Orecchia, Roberto
PY - 2014/3/5
Y1 - 2014/3/5
N2 - Rationale: to evaluate the role of 18F-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) integrated with computer tomography (CT) scan [18F]FDG-PET/CT in the staging and target volume definition in Intensity Modulated RapidarcTM Delivery (RA-IMRT) in cervical cancer. Methods: From June 2010 to December 2011, 66 patients affected by cervical cancer, candidates for definitive or adjuvant radiochemotherapy, underwent standard staging with CT and magnetic resonance imaging (MRI). All patients underwent [18F]FDG-PET/CT in order to exclude distant metastases and to define gross tumor volume (GTV). 40 and 26 patients received exclusive and adjuvant radiotherapy, respectively. RA-IMRT with simultaneous integrated boost (SIB) to the positive disease technique was employed. Results: [18F]FDG-PET/CT has changed the stage, and radiotherapy treatment planning was modified in 25% and 7.7% of patients that received definitive and adjuvant radiotherapy, respectively. Particularly [18F]FDG-PET/CT imaging showed metabolically active tumor in lymph nodes area, therefore the stage and the treatment planning changed for these patients. Conclusions: [ 18F]FDG-PET/CT leads to a better staging and definition of disease and has the potential of showing lymph-node metastasis not only within the pelvis but also in the para-aortic area. In addition, [18F]FDG-PET/CT is useful for better definition of the target volume and to produce a 'dose painted' treatment. This might also open the field for escalation dose regimens.
AB - Rationale: to evaluate the role of 18F-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) integrated with computer tomography (CT) scan [18F]FDG-PET/CT in the staging and target volume definition in Intensity Modulated RapidarcTM Delivery (RA-IMRT) in cervical cancer. Methods: From June 2010 to December 2011, 66 patients affected by cervical cancer, candidates for definitive or adjuvant radiochemotherapy, underwent standard staging with CT and magnetic resonance imaging (MRI). All patients underwent [18F]FDG-PET/CT in order to exclude distant metastases and to define gross tumor volume (GTV). 40 and 26 patients received exclusive and adjuvant radiotherapy, respectively. RA-IMRT with simultaneous integrated boost (SIB) to the positive disease technique was employed. Results: [18F]FDG-PET/CT has changed the stage, and radiotherapy treatment planning was modified in 25% and 7.7% of patients that received definitive and adjuvant radiotherapy, respectively. Particularly [18F]FDG-PET/CT imaging showed metabolically active tumor in lymph nodes area, therefore the stage and the treatment planning changed for these patients. Conclusions: [ 18F]FDG-PET/CT leads to a better staging and definition of disease and has the potential of showing lymph-node metastasis not only within the pelvis but also in the para-aortic area. In addition, [18F]FDG-PET/CT is useful for better definition of the target volume and to produce a 'dose painted' treatment. This might also open the field for escalation dose regimens.
KW - Cervical cancer
KW - IMRT
KW - Rapidarc radiotherapy
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U2 - 10.3332/ecancer.2014.409
DO - 10.3332/ecancer.2014.409
M3 - Article
AN - SCOPUS:84897410204
VL - 8
JO - ecancermedicalscience
JF - ecancermedicalscience
SN - 1754-6605
IS - 1
M1 - 409
ER -