Sarcomas:: Al after 1 chemo PET scan can determine if chemotherapy is working in aggressive forms of soft tissue sarcoma. Article posted April 18, 2009.

April 18, 2009: Source: 1: Clin Cancer Res. 2009 April 1915, 15 (8) :2856-2863. Epub 2009 Apr 7. Click here to read

Already after 1 chemo PET scan can determine if chemotherapy is working in aggressive forms of soft tissue sarcoma. This emerges from a first study in which the sugar intake of cancer cells a predictor for whether or not proved effective in the chemotherapy. If there were more than 35% reduction in sugar intake was found 100% effective chemotherapy. compared to 65% in the group less than 35% reduction in sugar intake had the cancer. It seems a small study by researchers but this is seen as an important outcome.

Histopathologic FDG-PET/CT Imaging Predict Treatment Response after the Initial Cycle of neoadjuvant Chemotherapy in High-Grade Soft Tissue Sarcomas.

Benz MR , Czernin J , Allen-Auerbach MS , Tap WD , Dry SM , Elashoff D , Chow K , Evilevitch V , Eckardt JJ , Phelps ME , Weber WA , Eilber FC .

Authors' Affiliations: Ahmanson Biological Imaging Division, Department of Molecular and Medical Pharmacology, Divisions of Medical Oncology and Orthopedic Oncology, Departments of Pathology, Biostatistics, and Radiology, and Division of Surgical Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California and Abteilung Nuklearmedizin, University of Freiburg, Freiburg, Germany.

PURPOSE: In patients with soft tissue sarcoma (STS), the early assessment of treatment responses is important. Using positron emission tomography / computed tomography (PET / CT) with [(18) F] fluorodeoxyglucose (FDG), we Determined whethere changes in tumor FDG uptake predict histopathologic treatment responses in high-grade STS after the initial cycle of neoadjuvant chemotherapy.

EXPERIMENTAL DESIGN: From February 2006 to March 2008, 50 patients with resectable high-grade STS scheduled for neoadjuvant therapy and subsequent component tumor resection Were enrolled prospectively. FDG-PET/CT before (baseline), after the first cycle (early follow-up), and after completion of neoadjuvant therapy (late follow-up) was done. Tumor FDG uptake and changes Were Measured by standardized uptake values. Histopathologic Examination of the resected specimen Provided an assessment or treatment response. Patients with> / = 95% necrosis pathology Were classified as treatment responders. Were FDG-PET/CT results compared with histopathologic findings.

RESULTS: At early follow-up, significantly more Decreased FDG uptake in 8 (16%) responders in the Than 42 (84%), nonresponders (-55% versus -23%, P = 0.002). All responders and 14 nonresponders and 42 had a> / = 35% reduction in the standardized uptake value Between baseline and early follow-up. Using a> / = 35% reduction in FDG uptake as early metabolic response threshold resulted in a sensitivity and specificity of FDG-PET for histopathologic response or 100% and 67%, respectively. Applying a higher threshold at late follow-up improved specificity but not sensitivity. CT had no value at response prediction.

CONCLUSION: A 35% reduction in tumor FDG uptake at early follow-up is a sensitive predictor of histopathologic tumor response. Early treatment discontinuation or décisions Such As chemotherapy in nonresponding patiënten Could Be based on FDG-PET criteria.

PMID: 19351756 [PubMed - as supp song by publisher]