• Radiology
• Reproductive Cancers
• Radiation Therapy
• Oncology Clinical Trials
• Reproductive Cancers

• Radiology
• Reproductive Cancers
• Radiation Therapy
• Oncology Clinical Trials
• Oncology

Prescreens for extrapelvic lymph node metastases using ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) did not enhance survival rate but reduced the use of extended-field concurrent chemoradiation (CCRT). Ji-Hong Hong, MD, PhD, Chang Gung Memorial Hospital, Taoyuan, Taiwan, presented results of this prospective phase 3 trial.

Patients with cervical cancer in whom magnetic resonance imaging (MRI) identifies enlarged pelvic nodes may undergo further imaging with FDG-PET for further characterization. This study examined the impact of additional imaging on targeted radiation treatment and patient outcomes.

A total of 129 patients recently diagnosed with stage I to IVA cervical cancer participated in this study and had MRI-confirmed positive pelvic and negative para-aortic lymph nodes (PALNs). Patients were randomized to either a study group (51%) receiving FDG-PET or a control group (49%) assessed only by MRI. The FDG-PET group received irradiation with fields based on extrapelvic findings, while the control group received irradiation of the whole pelvic field.

There was no difference in freedom from extrapelvic metastasis between the FDG-PET and control groups (82.4% vs 75.8%, P = .40). The 5-year survival rate for patients with relapse in the FDG-PET group was 0% compared with 30% in the control group. FDG-PET revealed extrapelvic metastases in 7 patients (11%), and PALN relapse occurred in 5 patients (8%). In the control group, 10 patients (16%) experienced PALN relapse.

The overall survival rate between groups was similar (68.2% vs 74.1%, P = .55), as well as disease-free survival (66.8% vs 71.0%, P = .72). Pretreatment FDG-PET showed that 18 patients had just a primary tumor; their disease-free survival rate of 94.5% was significantly better than that of all other patients.

The authors concluded that despite the lack of differences between the groups, the specificity of FDG-PET findings reduced the need for extended CCRT of nearby regions and can be a helpful pretreatment tool for targeted therapy.

• © 2014 MD Conference Express®