18F-FDG PET/CT following
chemoradiation of uterine cervix cancer provides powerful prognostic stratification independent of HPV status: a prospective cohort of 105 women with mature survival data Shankar Siva, Siddhartha Deb, Richard J. Young, Rodney J. Hicks, Jason Callahan, et al. European Journal of Nuclear Medicine and Molecular Imaging ISSN 1619-7070 Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-015-3112-8
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Author's personal copy Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-015-3112-8
ORIGINAL ARTICLE
18
F-FDG PET/CT following chemoradiation of uterine cervix cancer provides powerful prognostic stratification independent of HPV status: a prospective cohort of 105 women with mature survival data
Shankar Siva 1,2 & Siddhartha Deb 3 & Richard J. Young 4 & Rodney J. Hicks 1,2 & Jason Callahan 1,2 & Mathias Bressel 5 & Linda Mileshkin 6 & Danny Rischin 2,6 & David Bernshaw 1 & Kailash Narayan 1
Received: 9 March 2015 / Accepted: 7 June 2015 # Springer-Verlag Berlin Heidelberg 2015
Abstract Purpose To report 5-year outcomes of a prospective registry study investigating posttherapy FDG PET/CT in women with locally advanced cervical cancer. A secondary analysis assessing the prognostic significance of HPV infection was performed. Methods Patients underwent definitive chemoradiation followed by a single FDG PET/CT scan for response assessment. A complete metabolic response (CMR) was defined as no evidence of FDG-avid disease. Patients were dichotomized according to HPV infection status into a ‘higher-risk’ group and a ‘lower-risk’ group, with the higher-risk group comprising those with alpha-7 strain HPV (subtypes 18, 39 and 45) and those who were HPV-negative and the lower-risk group comprising those with alpha-9 strain HPV (subtypes 16, 31,
* Shankar Siva
[email protected] 1
Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, St Andrews Street, East Melbourne 3002, Victoria, Australia
2
Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
3
Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia
4
Molecular Therapeutics and Biomarkers Laboratory, Peter MacCallum Cancer Centre, East Melbourne, Australia
5
Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Australia
6
Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Australia
33, 52 and 58) and those with mixed strains. Survival outcomes, patterns of failure and salvage therapy outcomes were investigated for their association with metabolic response and HPV status. Results In 105 patients the median prospective follow-up was 5.2 years. The 5-year cancer-specific, overall and progression-free survival rates in patients with a CMR were 97 %, 93 % and 86 %, respectively. In patients without a CMR, the corresponding 5-year survival rates were 36 %, 22 % and 0 % respectively (p
