Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Prognostic value of pretreatment 18F-FDG PET-CT in radiotherapy for patients with hepatocellular carcinoma

  • Jo, In Young (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Son, Seok-Hyun (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Kim, Myungsoo (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Sung, Soo Yoon (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Won, Yong Kyun (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Kang, Hye Jin (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Lee, So Jung (Department of Radiation Oncology, the Catholic University of Korea College of Medicine) ;
  • Chung, Yong-An (Department of Radiology, the Catholic University of Korea College of Medicine) ;
  • Oh, Jin Kyoung (Department of Radiology, the Catholic University of Korea College of Medicine) ;
  • Kay, Chul-Seung (Department of Radiation Oncology, the Catholic University of Korea College of Medicine)
  • Received : 2015.04.29
  • Accepted : 2015.07.27
  • Published : 2015.09.30
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Abstract

Purpose: The purpose of this study was to investigate the predictable value of pretreatment $^{18}F$-fluorodeoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET-CT) in radiotherapy (RT) for patients with hepatocellular carcinoma (HCC) or portal vein tumor thrombosis (PVTT). Materials and Methods: We conducted a retrospective analysis of 36 stage I-IV HCC patients treated with RT. $^{18}F$-FDG PET-CT was performed before RT. Treatment target was determined HCC or PVTT lesions by treatment aim. They were irradiated at a median prescription dose of 50 Gy. The response was evaluated within 3 months after completion of RT using the Response Evaluation Criteria in Solid Tumors (RECIST). Response rate, overall survival (OS), and the pattern of failure (POF) were analyzed. Results: The response rate was 61.1%. The statistically significant prognostic factor affecting response in RT field was maximal standardized uptake value (maxSUV) only. The high SUV group (maxSUV ${\geq}5.1$) showed the better radiologic response than the low SUV group (maxSUV < 5.1). The median OS were 996.0 days in definitive group and 144.0 days in palliative group. Factors affecting OS were the %reduction of alpha-fetoprotein (AFP) level in the definitive group and Child-Pugh class in the palliative group. To predict the POF, maxSUV based on the cutoff value of 5.1 was the only significant factor in distant metastasis group. Conclusion: The results of this study suggest that the maxSUV of $^{18}F$-FDG PET-CT may be a prognostic factor for treatment outcome and the POF after RT. A %reduction of AFP level and Child-Pugh class could be used to predict OS in HCC.

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References

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