Aim. To evaluate the role of 18F-fluorodeoxyglucose (FDG) PET/CT in: a) the selection of patients with locally advanced pancreatic cancer for helical tomotherapy with concurrent chemotherapy (HTT-ChT); b) monitoring HTT-ChT treatment efficacy in comparison with contrast-enhanced CT (c.e.CT). Methods. Forty-two consecutive patients with unresectable locally advanced pancreatic cancer referred for HTT-ChT were enrolled in the study. All patients were pretreated with induction ChT. Before the beginning of HTT-ChT treatment patients underwent diagnostic c.e.CT (CT0) and FDG PET/CT (PET/CT0) for staging. After staging, patients received HTT-ChT. Three months after the end of HTT-ChT a control c.e.CT (CT1) was done. FDG PET/CT (PET/CT1) was repeated only in patients with positive PET/CT0. PET/CT1 and CT1 were compared with baseline imaging results to assess treatment efficacy. Results. In 31/42 cases (74%) PET/CT0 documented pathological uptake in pancreatic lesions, while in the remaining 11/42 cases it showed no uptake. In 7/42 (17%) patients, PET/CT0 also detected distant metastases, prompting a change in the therapeutic approach. Compared to PET/CT0, PET/CT1 (n = 18) documented 3 complete metabolic responses, 9 partial metabolic responses, 2 instances of stable metabolic disease, and 4 instances of progressive metabolic disease. In the same group of 18 patients, CT1 showed 0 complete responses, 3 partial responses, 8 instances of stable disease, and 7 instances of progressive disease compared to CT0. Concordance between PET/CT and CT response was seen in 33% of cases. In 50% of cases, PET/CT1 documented a response to therapy that was not evident on CT. Conclusions. PET/CT influenced the treatment strategy by detecting distant metastases not documented by CT, thus accurately selecting patients for HTT-ChT after induction ChT. In monitoring treatment efficacy, PET/CT can detect a metabolic response to treatment not identified by CT.
Picchio, M., Giovannini, E., Passoni, P., Busnardo, E., Landoni, C., Giovacchini, G., et al. (2012). Role of PET/CT in the clinical management of locally advanced pancreatic cancer. TUMORI, 98(5), 643-651 [10.1700/1190.13207].
|Citazione:||Picchio, M., Giovannini, E., Passoni, P., Busnardo, E., Landoni, C., Giovacchini, G., et al. (2012). Role of PET/CT in the clinical management of locally advanced pancreatic cancer. TUMORI, 98(5), 643-651 [10.1700/1190.13207].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||Si|
|Titolo:||Role of PET/CT in the clinical management of locally advanced pancreatic cancer|
|Autori:||Picchio, M; Giovannini, E; Passoni, P; Busnardo, E; Landoni, C; Giovacchini, G; Bettinardi, V; Crivellaro, C; Gianolli, L; Di Muzio, N; Messa, C|
|Data di pubblicazione:||2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1700/1190.13207|
|Appare nelle tipologie:||01 - Articolo su rivista|