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. 2020 Jun 18:24:83-87.
doi: 10.1016/j.ctro.2020.06.008. eCollection 2020 Sep.

Treatment outcome after radiochemotherapy in anal cancer patients staged with 18F-FDG-PET-CT

L H Braun  1   2 , C P Reinert  3 , D Zips  1   4 , K Nikolaou  3 , C Pfannenberg  3 , C Gani  1   4
Affiliations

Treatment outcome after radiochemotherapy in anal cancer patients staged with 18F-FDG-PET-CT

L H Braun et al. Clin Transl Radiat Oncol. .

Abstract

Background: Anal cancer (AC) is a malignancy with increasing incidence and commonly treated with radiochemotherapy. Positron-emission tomography-computed tomography (PET/CT) has been shown to improve treatment outcome in various oncological diseases, however, for AC long-term outcome data is sparse. The aim of the present study is therefore to report outcomes in our cohort of PET/CT staged AC patients treated with radiochemotherapy.

Methods: Patients with AC who were treated with radiochemotherapy in curative intent were included in this retrospective study if a PET/CT scan was performed pre-therapeutically. Information from PET/CT was considered for nodal and primary target volume definition. Radiotherapy dose to the primary tumor was 50-66 Gy and concomitant chemotherapy included 5-fluorouracil and mitomycin-C. The uptake of 18F-fluorodeoxyglucose (FDG) was quantified using 50%-isocontour volumes of interests (VOIs) and measuring the standardized uptake value (SUV) and the metabolic tumor volume (MTV).18F-FDG uptake was correlated with baseline clinical parameters and long-term oncological outcome. Survival estimates were determined according to Kaplan-Meier.

Results: A total of 60 patients were included in this study. Estimates for three-year overall survival (OS) and disease free survival (DFS) were 94.5% and 80%. Five patients developed local (n = 2) or locoregional and local (n = 3) failure. Baseline PET/CT related parameters correlated with primary tumor stage, nodal stage and tumor grading. DFS was independent of T-stage, N-stage and baseline 18F-FDG-uptake.

Conclusion: In this cohort of PET/CT staged AC patients, excellent outcomes for DFS were seen. PET-based markers of tumor burden correlate with local stage of AC, however, are not of prognostic relevance for disease-free survival.

Keywords: Anal cancer; PET; Radiochemotherapy; Radiotherapy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Disease-free survival in dependence of nodal stage (a), T-stage (b), metabolic tumor volume (MTV) (c), SUVmean (d). SUV- standardized uptake value, MTV – Metabolic tumor volume.
See this image and copyright information in PMC

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