scholarly journals Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Pierre Decazes ◽  
Hugues Auvray ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Cancer Patients ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Ct Images ◽  
Pet Ct ◽  
Nutritional Risk Index ◽  
Fdg Pet Ct

Abstract Background Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer patients treated by curative-intent chemo-radiotherapy. Methods The clinical, nutritional, anthropometric, and functional-imaging ( 18 FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution (RTEP3). The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3 rd . lumbar vertebra level and divided by the patient’s squared height (SML3/h 2 ) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability. Results Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that reduced SMI (Hazard Ratio 0.948 [0.919 - 0.978] and male sex (2.977 [1.427 - 6.213] were significantly associated to decreased survival. Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm 2 /m 2 . In women, the AUC was 0.65 (p=0.19). Conclusion Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18 FDG-PET/CT acquisitions

scholarly journals Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Sorina Dana Mihailescu ◽  
Pierre Decazes ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Ct Images ◽  
Significant Prognostic Factor ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions

scholarly journals Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Sorina Dana Mihailescu New ◽  
Pierre Decazes ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Ct Images ◽  
Significant Prognostic Factor ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions

THE ROLE OF 18-FDG PET-CT IN LOCALLY ADVANCED HEAD AND NECK CANCER PATIENTS: EARLY AND LATE RESPONSE TO RADIOCHEMOTHERAPY

2011 ◽  
Vol 98 ◽  
pp. S45-S46
Author(s):  
F. Micciche ◽  
F. Bussu ◽  
R. Autorino ◽  
M. Balducci ◽  
G. Chiloiro ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Late Response ◽  
Advanced Head ◽  
Pet Ct ◽  
Fdg Pet Ct

PD-0297: Outcomes in locally advanced cervical cancer patients treated radically with/without staging FDG-PET/CT

2014 ◽  
Vol 111 ◽  
pp. S115-S116
Author(s):  
E. Choong ◽  
S. Rodda ◽  
H. Musunuru ◽  
H. Thygesen ◽  
C. Patel ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Evolutionary dynamics at the tumor edge reveals metabolic imaging biomarkers

2020 ◽  
Author(s):  
Juan Jiménez-Sánchez ◽  
Jesús J. Bosque ◽  
Germán A. Jiménez Londoño ◽  
David Molina-García ◽  
Álvaro Martínez ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Metabolic Activity ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Small Cell ◽  
Peak Activity ◽  
Small Cell Lung ◽  
Human Cancers ◽  
Pet Ct ◽  
Fdg Pet Ct

Human cancers are biologically and morphologically heterogeneous. A variety of clonal populations emerge within these neoplasms and their interaction leads to complex spatio-temporal dynamics during tumor growth. We studied the reshaping of metabolic activity in human cancers by means of continuous and discrete mathematical models, and matched the results to positron emission tomography (PET) imaging data. Our models revealed that the location of increasingly active proliferative cellular spots progressively drifted from the center of the tumor to the periphery, as a result of the competition between gradually more aggressive phenotypes. This computational finding led to the development of a metric, the NPAC, based on the distance from the location of peak activity (proliferation) to the tumor centroid. The NPAC metric can be computed for human patients using 18F-FDG PET/CT images where the voxel of maximum uptake (SUVmax) is taken as the point of peak activity. Two datasets of 18F-FDG PET/CT images were collected, one from 61 breast cancer patients and another from 161 non-small-cell lung cancer patients. In both cohorts, survival analyses were carried out for the NPAC and for other classical PET/CT-based biomarkers, finding that the former had a high prognostic value, outperforming the latter. In summary, our work offers new insights into the evolutionary mechanisms behind tumor progression and provides a PET/CT-based biomarker with clinical applicability.Significance StatementThrough the use of different in silico modeling approaches capturing tumor heterogeneity, we predicted that areas of high metabolic activity would shift towards the periphery as tumors become more malignant. To confirm the prediction and provide clinical value for the finding, we took 18F-FDG PET images of breast cancers and non-small-cell lung cancers, where we measured the distance from the point of maximum activity to the tumor centroid, and normalized it by a surrogate of the volume. We show that this metric has a high prognostic value for both malignancies and outperforms other classical PET-based metabolic biomarkers used in oncology.

scholarly journals Prognostic value of 18F-FDG PET/CT before and after radiotherapy for locally advanced nasopharyngeal carcinoma

2010 ◽  
Vol 21 (5) ◽  
pp. 1078-1082 ◽  
Author(s):  
P. Xie ◽  
J.-B. Yue ◽  
Z. Fu ◽  
R. Feng ◽  
J.-M. Yu
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Pet Ct ◽  
Before And After ◽  
18F Fdg ◽  
Fdg Pet Ct

RA07.06: BASELINE FDG-PET/CT PARAMETERS AS PREDICTOR FOR RESIDUAL TUMOUR AFTER NEOADJUVANT CHEMORADIOTHERAPY IN OESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 35-35
Author(s):  
Maria Valkema ◽  
B Noordman ◽  
Bas P L Wijnhoven ◽  
M C W Spaander ◽  
Sjoerd M Lagarde ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Lean Body Mass ◽  
Body Mass ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumour Mass ◽  
Residual Tumour ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background An optimal model for predicting pathologic response after neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer has not been defined yet. FDG-PET/CT is frequently used in response assessments. The aim of this side study of the preSANO trial (NL41732.078.13) was to investigate if the FDG-PET parameters SUVmax, total lesion glycolysis (TLG) and metabolic tumour volume (MTV) were predictive for residual tumour in the resected specimen of oesophageal cancer patients treated with nCRT. Methods Patients underwent FDG-PET/CT at baseline according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.). All parameters were corrected for lean body mass. MTV was defined as the volume within a 41% of SULmax ( = SUV/lean body mass) isocontour threshold at tumour and lymph nodes. TLG was calculated as SULmean x MTV. Logarithmic transformation was performed because of non-normal distribution of TLG and MTV. Baseline PET parameters were compared to tumour regression grade in the resection specimen (TRG3–4 = > 10% residual tumour vs. TRG1 = complete response). Peroperatively irresectable tumours were recoded as TRG4. Analyses were performed using an independent-samples T-test. Results From a total of 207 patients who underwent FDG-PET/CT before nCRT, 197 were included for analysis (5 were non-FDG avid, 5 had incomplete data). Histological type of tumour: adenocarcinoma (AC) n = 154, squamous cell carcinoma (SCC) n = 42, and one adenosquamous carcinoma. Thirty-seven patients (19%) had TRG1 and 41 patients (21%) had TRG3–4. In complete responders (TRG1), SULmax, TLG and MTV (mean ± SD) were 9.6 ± 5.8, 85.3 ± 85.5 and 13.0 ± 9.9, respectively. In patients with TRG3–4, SULmax, TLG and MTV were 9.4 ± 5.4145.8 ± 164.6 and 21.9 ± 16.2, respectively. SULmax was not significantly different between both groups (P = 0.8), but log(TLG) and log(MTV) (P = 0.008 and P = 0.001) were. In adenocarcinomas, log(TLG) did not differ between groups (P = 0.1). Conclusion Initial FDG tumour mass, expressed as MTV, (rather than SULmax) is the most contributing factor in predicting residual disease after nCRT in both SCC and AC. The effect is stronger in SCC. Therefore, baseline FDG tumour mass should be included in a prediction model, besides other clinical and tumour parameters. Disclosure All authors have declared no conflicts of interest.

Sign in / Sign up

Export Citation Format

Share Document