Beck, M. and Hartwich, J. and Eckstein, M. and Schmidt, D. and Gostian, A. O. and Mueller, S. and Rutzner, S. and Gaipl, U. S. and von der Gruen, J. and Illmer, T. and Hautmann, M. G. and Klautke, G. and Doescher, J. and Brunner, T. and Tamaskovics, B. and Hartmann, A. and Iro, H. and Kuwert, T. and Fietkau, R. and Hecht, M. and Semrau, S. (2022) F18-FDG PET/CT imaging early predicts pathologic complete response to induction chemoimmunotherapy of locally advanced head and neck cancer: preliminary single-center analysis of the checkrad-cd8 trial. ANNALS OF NUCLEAR MEDICINE, 36 (7). pp. 623-633. ISSN 0914-7187, 1864-6433
Full text not available from this repository. (Request a copy)Abstract
Aim In the CheckRad-CD8 trial patients with locally advanced head and neck squamous cell cancer are treated with a single cycle of induction chemo-immunotherapy (ICIT). Patients with pathological complete response (pCR) in the re-biopsy enter radioimmunotherapy. Our goal was to study the value of F-18-FDG PET/CT in the prediction of pCR after induction therapy. Methods Patients treated within the CheckRad-CD8 trial that additionally received FDG- PET/CT imaging at the following two time points were included: 3-14 days before (pre-ICIT) and 21-28 days after (post-ICIT) receiving ICIT. Tracer uptake in primary tumors (PT) and suspicious cervical lymph nodes (LN +) was measured using different quantitative parameters on EANM Research Ltd (EARL) accredited PET reconstructions. In addition, mean FDG uptake levels in lymphatic and hematopoietic organs were examined. Percent decrease (Delta) in FDG uptake was calculated for all parameters. Biopsy of the PT post-ICIT acquired after FDG-PET/CT served as reference. The cohort was divided in patients with pCR and residual tumor (ReTu). Results Thirty-one patients were included. In ROC analysis, Delta SUVmax PT performed best (AUC = 0.89) in predicting pCR (n = 17), with a decline of at least 60% (sensitivity, 0.77; specificity, 0.93). Residual SUVmax PT post-ICIT performed best in predicting ReTu (n = 14), at a cutpoint of 6.0 (AUC = 0.91; sensitivity, 0.86; specificity, 0.88). Combining two quantitative parameters (Delta SUVmax >= 50% and SUVmax PT post-ICIT <= 6.0) conferred a sensitivity of 0.81 and a specificity of 0.93 for determining pCR. Background activity in lymphatic organs or uptake in suspected cervical lymph node metastases lacked significant predictive value. Conclusion FDG-PET/CT can identify patients with pCR after ICIT via residual FDG uptake levels in primary tumors and the related changes compared to baseline. FDG-uptake in LN + had no predictive value. Trial registry ClinicalTrials.gov identifier: NCT03426657.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SQUAMOUS-CELL CARCINOMA; LUNG-CANCER; FDG-PET/CT; IMMUNOTHERAPY; CHEMOTHERAPY; CHEMORADIATION; THERAPY; SURGERY; Immunotherapy; HNSCC; Head neck cancer; FDG-PET; CT; Induction therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Strahlentherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Feb 2024 08:12 |
| Last Modified: | 01 Feb 2024 08:12 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58472 |
Actions (login required)
 |
View Item |
