Universität zu Köln

Wollring, Michael M., Werner, Jan-Michael ORCID: 0000-0001-7147-4594, Bauer, Elena K., Tscherpel, Caroline, Ceccon, Garry S., Lohmann, Philipp, Stoffels, Gabriele, Kabbasch, Christoph, Goldbrunner, Roland, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Langen, Karl-Josef and Galldiks, Norbert . Prediction of response to lomustine-based chemotherapy in glioma patients at recurrence using MRI and FET PET. Neuro-Oncology. CARY: OXFORD UNIV PRESS INC. ISSN 1523-5866

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Abstract

Background We evaluated O-(2-[F-18]fluoroethyl)-l-tyrosine (FET) PET and MRI for early response assessment in recurrent glioma patients treated with lomustine-based chemotherapy. Methods Thirty-six adult patients with WHO CNS grade 3 or 4 gliomas (glioblastoma, 69%) at recurrence (median number of recurrences, 1; range, 1-3) were retrospectively identified. Besides MRI, serial FET PET scans were performed at baseline and early after chemotherapy initiation (not later than two cycles). Tumor-to-brain ratios (TBR), metabolic tumor volumes (MTV), the occurrence of new distant hotspots with a mean TBR >1.6 at follow-up, and the dynamic parameter time-to-peak were derived from all FET PET scans. PET parameter thresholds were defined using ROC analyses to predict PFS of >= 6 months and OS of >= 12 months. MRI response assessment was based on RANO criteria. The predictive values of FET PET parameters and RANO criteria were subsequently evaluated using univariate and multivariate survival estimates. Results After treatment initiation, the median follow-up time was 11 months (range, 3-71 months). Relative changes of TBR, MTV, and RANO criteria predicted a significantly longer PFS (all P <= .002) and OS (all P <= .045). At follow-up, the occurrence of new distant hotspots (n >= 1) predicted a worse outcome, with significantly shorter PFS (P = .005) and OS (P < .001). Time-to-peak changes did not predict a significantly longer survival. Multivariate survival analyses revealed that new distant hotspots at follow-up FET PET were most potent in predicting non-response (P < .001; HR, 8.578). Conclusions Data suggest that FET PET provides complementary information to RANO criteria for response evaluation of lomustine-based chemotherapy early after treatment initiation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wollring, Michael M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, Jan-Michael UNSPECIFIED orcid.org/0000-0001-7147-4594 UNSPECIFIED Bauer, Elena K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tscherpel, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Ceccon, Garry S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmann, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-687943
DOI:	10.1093/neuonc/noac229
Journal or Publication Title:	Neuro-Oncology
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1523-5866
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; O-(2-F-18-FLUOROETHYL)-L-TYROSINE PET; NEUROONCOLOGY; RECOMMENDATIONS; CLASSIFICATION; BEVACIZUMAB; PATTERNS; SYSTEM; TUMORS Multiple languages Oncology; Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68794