S.H.C and J.S.C contributed equally to this work as co-first authors.
FDG-PET predicts outcomes of treated bone metastasis following palliative radiotherapy in patients with hepatocellular carcinoma
Article first published online: 6 MAR 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 7, pages 1118–1125, August 2014
How to Cite
Liver Int. 2014: 34: 1118–1125
This research was presented at 55th Annual Meeting of the American Society of Radiation Oncology (ASTRO), September 22-25, 2013, Atlanta.
- Issue published online: 17 JUL 2014
- Article first published online: 6 MAR 2014
- Accepted manuscript online: 15 FEB 2014 12:39AM EST
- Manuscript Accepted: 1 FEB 2014
- Manuscript Received: 24 APR 2013
- Ministry of Health and Welfare, Republic of Korea. Grant Number: 0620390
- bone metastasis;
- hepatocellular carcinoma;
- SUV ratio
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.
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).
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).
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.