The Impact of PET in Radiotherapy of the Cervical Carcinoma – Results of Pilot Study
Authors:
H. Doleželová 1; P. Šlampa 1; K. Bolčák 2; J. Gombošová 1; B. Ondrová 1; T. Novotný 1; L. Hynková 1; J. Růžičková 1; M. Forbelská 3
Authors‘ workplace:
Klinika radiační onkologie LF MU a MOÚ, Brno, přednosta prof. MUDr. P. Šlampa, CSc.
1; Masarykův onkologický ústav, odd. nukleární medicíny, Brno
2; Přírodovědecká fakulta MU, Katedra aplikované matematiky, Brno
3
Published in:
Ceska Gynekol 2008; 73(3): 135-140
Overview
Objective:
Positron emission tomography (PET) is a complementary method to determine target volumes in radiotherapy. Daily using of PET in the oncology praxis can change treatment strategy and improve its outcome. Results of this pilot study show the role of PET in staging of cervical carcinoma and in the radiotherapeutic planning.
Methods:
Between March 2005 and May 2007, 51 patients with cervical carcinoma were treated with combination of external beam radiotherapy and HDR brachytherapy, with or without concomitant cisplatin. The lymphatic nodes treatment field size was determined by PET/CT fusion.
Results:
The difference in the results of PET and CT was evaluated in this study. In 32 cases (62.75%) the results of PET and CT were identical, in 14 cases (27.45%) the nodal involvement was more extensive according to PET, in 5 cases (9.8%) the nodal involvement was more extensive according to CT. PET results 3 months after treatment were as follows: in 3 cases (5.88%) stable disease, in 35 cases (68.63%) negative, in 4 cases (7.84%), progression of disease, in 3 cases (5.88%) partial regression.
Conclusion:
The results of this study confirmed the important role of PET in diagnosis and treatment of cervical carcinoma and in determination of target volumes in radiotherapy. PET was found to be a standard staging examination of cervical carcinoma in Masaryk Memorial Cancer Institute.
Key words:
positron emission tomography, radiotherapy, cervical carcinoma.
Sources
1. Belhocine, T., Thille, A., Fridman, V., et al. Contribution of whole-body 18FDG PET imaging in the management of cervical cancer. Gynecol Oncol, 2002, 87, 1, p. 90-97.
2. Bujenovic, S. The role of positron emission tomography in radiation treatment planning. Sem Nucl Med, 2004, 34, 4, p. 293-299.
3. Cohade, C., Wahl, R. Applications of positron emission tomography/computed tomography image fusion in clinical positron emission tomography-clinical use, interpretation methods, diagnostic improvement. Sem Nucl Med, 2003, 33, p. 228-237.
4. Dolezelova, H., Slampa, P. The impact of positron emission tomography in the radiotherapy treatment planning. Neoplasma, 2007, 54, 2, p. 95-100.
5. Gambhir, SS., Czernin, J., Schwimmer, J., et al. A tabulated summary of the FDG-PET literature. J Nucl Med, 2001, 42, p. S1-S93.
6. Grigsby, PW., Siegel, BA,, Dehdashti, F. Lymph node staging by positron emission tomography in patients with carcinoma of the cervix. J Clin Oncol, 2001, 19, 17, p. 3745-3749.
7. Grigsby, PW., Siegel, BA., Dehdashti, F. Posttherapy surveillance monitoring of cervical cancer by FDG-PET. Int J Radiat Oncol Biol Phys, 2003, 55, p. 907-913.
8. Grosu, AL., Piert, M., Weber, WA., et al. Positron emission tomography for radiation treatment planning. Strahlenther Oncol, 2005, 8, p. 483-499.
9. Horová, H., Hynková, L., Košťáková, Š., et al. Využití pozitronové emisní tomografie v radioterapii. Klin Onkol, 2004, 17, 6, s. 201-202.
10. Ichiya, Y., Kuwabara, Y., Otsuka, M., et al. Assesment of response to cancer therapy using fluorine-18-fluorodeoxyglicose and positron emission tomography. J Nucl Med, 1991, 32, p. 1655-1660.
11. Koike, I., Ohmura, M., Hata, M., et al. FDG-PET scanning after radiation can predict tumor regrowth three months later. Int J Radiat Oncol Biol Phys, 2003, 57, 5, p. 1231-1238.
12. Miller, TR., Pinkus, E., Desdashi, F., et al. Improved prognostic value of 18F-FDG PET using a simple visual analysis of tumor characteristics in patients with cervical cancer. J Nucl Med, 2003, 44, 2, p. 192-197.
13. Mutic, S., Malyapa, RS., Grigsby, PW., et al. PET-guided IMRT for cervical carcinoma with positive para-aortic lymph nodes- a dose-escalation treatment planning study. Int J Radiat Oncol Biol Phys, 2003, 55, 1, p. 28-35.
14. Nakamoto, Y., Eisbruch, A., Achtyes, ED., et al. Prognostic value of positron tomography using F-18-Fluorodeoxyglucose in patients with cervical cancer undergoing radiotherapy. Gynecol Oncol, 2002, 84, p. 289-295.
15. Perez, CA., Brady, LW. (Ed.) Principles & Practice of Radiation Oncology, 4rd ed., Philadelphia: Lippincott&Wilkins, 2004. p. 791-896.
16. Pluta, M. Současné trendy operační léčby u karcinomu děložního hrdla. Referátový výběr z onkologie. Gynekologické malignity – speciál, 2007, 2, s. 19-23.
17. Rob, L. Epidemiologie gynekologických nádorů v ČR - současné trendy prevence a léčby gynekologických nádorů. Referátový výběr z onkologie. Gynekologické malignity – speciál, 2007, 2, s. 3-7.
18. Rob, L., Svoboda, B., Robová, H., et al. Guideline gynekologických zhoubných nádorů 2004 - Primární komplexní léčba operabilních stadií zhoubných nádorů děložního hrdla. Čes Gynek, 2004, 5, s. 376-383.
19. Rose, PG., Adler, LP., Rodriguez, M., et al. Positron emission tomography for evaluating para-aortic nodal metastasis in locally advanced cervical cancer before surgical staging:A surgicopathologic study. J Clin Oncol, 1999, 17, 1, p. 41-45.
20. Ryu, SY., Kim, MH., Choi, SC., et al. Detection of early recurrence with 18F-FDG PET in patients with cervical cancer. J Nucl Med, 2003, 44, 3, p. 347-352.
21. Singh, AK., Grigsby, PW,, Dehdashti, F., et al. PDG-PET lymf node staging and survival of patients with FIGO stage IIIb cervical carcinoma. Int J Radiat Oncol Biol Phys, 2003, 56, 2, p. 489-493.
22. Stankušová, H., Šlampa, P. Zhoubné nádory děložního hrdla. In Šlampa, P., Petera, J. et al. Radiační onkologie. 1. ed. Praha: Galén, 2007. s. 247-262.
23. Šlampa, P., Soumarová, R., Kocáková, I., et al. Konkomitantní chemoradioterapie solidních nádorů. 1. ed. Praha: Grada, 2005. 168 s.
24. Šlampa, P., a kol. Radiační onkologie v praxi. Druhé aktualizované vydání. Masarykův onkologický ústav, Brno, 2007, s. 126-135.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
![Issue 3](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/21e6335f4818437f0c16878329d6eb5b.jpeg)
2008 Issue 3
Most read in this issue
- Preterm Premature Rupture of Membranes and Ureaplasma urealyticum
- Postpartal Atraumatic Sacral Fracture. A Case Report and Biomechanical Comments
- Sclerosing Stromal Tumor – a Rare Benign Ovarian Neoplasm
- Etiopathogenesis of Uterine Fibroid: Current Knowledge