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FDG ‐ PET predicts outcomes of treated bone metastasis following palliative radiotherapy in patients with hepatocellular carcinoma
Author(s) -
Choi Seo Hee,
Chang Jee Suk,
Jeong Yong Hyu,
Lee Youngin,
Yun Mijin,
Seong Jinsil
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12487
Subject(s) - medicine , hepatocellular carcinoma , nuclear medicine , response evaluation criteria in solid tumors , toxicity , phases of clinical research
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 ‐ PET s 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.