Clinical significance of the maximum standardized uptake value on positron emission tomography to predict treatment response and outcomes in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy

期刊论文
发表日期：

2024年6月15日

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Takao Tsuneki,
Takeru Matsuda,
Ryuichiro Sawada,
Hiroshi Hasegawa,
Kimihiro Yamashita,
Yasufumi Koterazawa,
Hitoshi Harada,
Naoki Urakawa,
Hironobu Goto,
Shingo Kanaji,
Yoshihiro Kakeji

摘要

Purposes

The association between the reduction rate of the maximum standardized uptake value (SUVmax) on positron emission tomography (PET) during neoadjuvant chemoradiotherapy (NACRT) and the prognosis in patients with locally advanced rectal cancer is unknown.

Methods

We retrospectively analyzed 62 patients with locally advanced rectal cancer who underwent curative surgery after NACRT at Kobe University between 2008 and 2021. The SUVmax reduction rate was calculated from preoperative and postoperative PET scans, and its association with the prognosis was investigated.

Results

The cutoff value for SUVmax reduction rate was 61.5%. Twenty patients had an SUVmax reduction rate > 61.5% (SUV responder group) and 38 patients had an SUVmax reduction rate ≤ 61.5% (SUV nonresponder group). Regarding pathological outcomes, the rate of a good histological response was significantly higher in the SUV responder group than in the SUV nonresponder group (80.0% vs. 21.1%, p < 0.001). Both the overall (OS) and relapse-free survival (RFS) rates were significantly better in the SUV responder group than in the SUV nonresponder group (OS, p = 0.035; RFS, p = 0.019). In the SUV responder group, only 1 case of recurrence was observed, with a median follow-up period of 56 months.

Conclusion

The rate of SUVmax reduction during NACRT might predict the long-term prognosis of patients with locally advanced rectal cancer.