FDG-PET predicts outcomes of treated bone metastasis following palliative radiotherapy in patients with hepatocellular carcinoma

Seo Hee Choi, Jee Suk Chang, Yong Hyu Jeong, Youngin Lee, Mijin Yun, Jinsil Seong

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Aims: To determine the utility of FDG-PET in predicting long-term infield tumour control after RT in patients with metastatic hepatocellular carcinoma (HCC) to bone. Methods: Among 223 patients with HCC skeletal metastases diagnosed, we reviewed 22 patients with 45 total sites treated with RT who had at least two FDG-PETs prior to and after RT. The median RT dose was 42 Gy (range, 22-48) with a median fraction of 3 Gy (range, 2-8). Helical tomotherapy was generally offered for lesions that received higher RT dose (36%). The intrahepatic control rate in all patients was 73% at the time of referral. The ratio of tumour SUV to blood-pool activity SUV (SUV-ratio) was calculated. The primary end-points were infield progression-free survival (infield-PFS) and infield event-free survival (infield-EFS; recurrent and intractable pain or skeletal-related events). Results: Among 45 sites, 20 had tumour progression and 21 developed events in the previously treated area. A higher SUV-ratio before RT, SUV-ratio decline and higher radiation dose were independently and significantly correlated with better infield-PFS (both P < 0.05). The tumours with a pre-RT SUV-ratio ≥3.0 and SUV-ratio decline ≥40% had significantly better infield-PFS and EFS than those with either a pre-RT SUV-ratio <3.0 or SUV-ratio decline <40% (both P < 0.05). Conclusions: FDG-PET may help to predict outcomes of infield tumour control following palliative RT for treatment of HCC bone metastases. Tumours with low metabolic uptake before RT or with a minor decline in post-RT SUV-ratio showed poor long-term infield tumour control.

Original languageEnglish
Pages (from-to)1118-1125
Number of pages8
JournalLiver International
Volume34
Issue number7
DOIs
Publication statusPublished - 2014 Jan 1

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Hepatocellular Carcinoma
Radiotherapy
Neoplasm Metastasis
Bone and Bones
Disease-Free Survival
Neoplasms
Intensity-Modulated Radiotherapy
Intractable Pain
Palliative Care
Referral and Consultation
Radiation

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Choi, Seo Hee ; Chang, Jee Suk ; Jeong, Yong Hyu ; Lee, Youngin ; Yun, Mijin ; Seong, Jinsil. / FDG-PET predicts outcomes of treated bone metastasis following palliative radiotherapy in patients with hepatocellular carcinoma. In: Liver International. 2014 ; Vol. 34, No. 7. pp. 1118-1125.
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abstract = "Aims: To determine the utility of FDG-PET in predicting long-term infield tumour control after RT in patients with metastatic hepatocellular carcinoma (HCC) to bone. Methods: Among 223 patients with HCC skeletal metastases diagnosed, we reviewed 22 patients with 45 total sites treated with RT who had at least two FDG-PETs prior to and after RT. The median RT dose was 42 Gy (range, 22-48) with a median fraction of 3 Gy (range, 2-8). Helical tomotherapy was generally offered for lesions that received higher RT dose (36{\%}). The intrahepatic control rate in all patients was 73{\%} at the time of referral. The ratio of tumour SUV to blood-pool activity SUV (SUV-ratio) was calculated. The primary end-points were infield progression-free survival (infield-PFS) and infield event-free survival (infield-EFS; recurrent and intractable pain or skeletal-related events). Results: Among 45 sites, 20 had tumour progression and 21 developed events in the previously treated area. A higher SUV-ratio before RT, SUV-ratio decline and higher radiation dose were independently and significantly correlated with better infield-PFS (both P < 0.05). The tumours with a pre-RT SUV-ratio ≥3.0 and SUV-ratio decline ≥40{\%} had significantly better infield-PFS and EFS than those with either a pre-RT SUV-ratio <3.0 or SUV-ratio decline <40{\%} (both P < 0.05). Conclusions: FDG-PET may help to predict outcomes of infield tumour control following palliative RT for treatment of HCC bone metastases. Tumours with low metabolic uptake before RT or with a minor decline in post-RT SUV-ratio showed poor long-term infield tumour control.",
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FDG-PET predicts outcomes of treated bone metastasis following palliative radiotherapy in patients with hepatocellular carcinoma. / Choi, Seo Hee; Chang, Jee Suk; Jeong, Yong Hyu; Lee, Youngin; Yun, Mijin; Seong, Jinsil.

In: Liver International, Vol. 34, No. 7, 01.01.2014, p. 1118-1125.

Research output: Contribution to journalArticle

TY - JOUR

T1 - FDG-PET predicts outcomes of treated bone metastasis following palliative radiotherapy in patients with hepatocellular carcinoma

AU - Choi, Seo Hee

AU - Chang, Jee Suk

AU - Jeong, Yong Hyu

AU - Lee, Youngin

AU - Yun, Mijin

AU - Seong, Jinsil

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Aims: To determine the utility of FDG-PET in predicting long-term infield tumour control after RT in patients with metastatic hepatocellular carcinoma (HCC) to bone. Methods: Among 223 patients with HCC skeletal metastases diagnosed, we reviewed 22 patients with 45 total sites treated with RT who had at least two FDG-PETs prior to and after RT. The median RT dose was 42 Gy (range, 22-48) with a median fraction of 3 Gy (range, 2-8). Helical tomotherapy was generally offered for lesions that received higher RT dose (36%). The intrahepatic control rate in all patients was 73% at the time of referral. The ratio of tumour SUV to blood-pool activity SUV (SUV-ratio) was calculated. The primary end-points were infield progression-free survival (infield-PFS) and infield event-free survival (infield-EFS; recurrent and intractable pain or skeletal-related events). Results: Among 45 sites, 20 had tumour progression and 21 developed events in the previously treated area. A higher SUV-ratio before RT, SUV-ratio decline and higher radiation dose were independently and significantly correlated with better infield-PFS (both P < 0.05). The tumours with a pre-RT SUV-ratio ≥3.0 and SUV-ratio decline ≥40% had significantly better infield-PFS and EFS than those with either a pre-RT SUV-ratio <3.0 or SUV-ratio decline <40% (both P < 0.05). Conclusions: FDG-PET may help to predict outcomes of infield tumour control following palliative RT for treatment of HCC bone metastases. Tumours with low metabolic uptake before RT or with a minor decline in post-RT SUV-ratio showed poor long-term infield tumour control.

AB - Aims: To determine the utility of FDG-PET in predicting long-term infield tumour control after RT in patients with metastatic hepatocellular carcinoma (HCC) to bone. Methods: Among 223 patients with HCC skeletal metastases diagnosed, we reviewed 22 patients with 45 total sites treated with RT who had at least two FDG-PETs prior to and after RT. The median RT dose was 42 Gy (range, 22-48) with a median fraction of 3 Gy (range, 2-8). Helical tomotherapy was generally offered for lesions that received higher RT dose (36%). The intrahepatic control rate in all patients was 73% at the time of referral. The ratio of tumour SUV to blood-pool activity SUV (SUV-ratio) was calculated. The primary end-points were infield progression-free survival (infield-PFS) and infield event-free survival (infield-EFS; recurrent and intractable pain or skeletal-related events). Results: Among 45 sites, 20 had tumour progression and 21 developed events in the previously treated area. A higher SUV-ratio before RT, SUV-ratio decline and higher radiation dose were independently and significantly correlated with better infield-PFS (both P < 0.05). The tumours with a pre-RT SUV-ratio ≥3.0 and SUV-ratio decline ≥40% had significantly better infield-PFS and EFS than those with either a pre-RT SUV-ratio <3.0 or SUV-ratio decline <40% (both P < 0.05). Conclusions: FDG-PET may help to predict outcomes of infield tumour control following palliative RT for treatment of HCC bone metastases. Tumours with low metabolic uptake before RT or with a minor decline in post-RT SUV-ratio showed poor long-term infield tumour control.

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