Amino-acid PET as a prognostic tool after post Stupp protocol temozolomide therapy in high-grade glioma patients

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2024年6月6日

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Adeline Zinsz,
Shamimeh Ahrari,
Jason Becker,
Ali Mortada,
Veronique Roch,
Louis Doriat,
Matthieu Santi,
Marie Blonski,
Luc Taillandier,
Timothée Zaragori,
Antoine Verger

摘要

Purpose

This study aimed to evaluate the prognostic performance of amino-acid PET in high-grade gliomas (HGG) patients at the time of temozolomide (TMZ) treatment discontinuation, after the Stupp protocol.

Methods

The analysis included consecutive HGG patients with dynamic [18F]FDOPA PET imaging within 3 months of the end of TMZ therapy, post-Stupp protocol. Static and dynamic PET parameters, responses to RANO criteria for MRI and clinical and histo-molecular factors were correlated to progression-free (PFS).

Results

Thirty-two patients (59.4 [54.0;67.6] years old, 13 (41%) women) were included. Static PET parameters peak tumor-to-background ratio and metabolic tumor volume (respective thresholds of 1.9 and 1.5 mL) showed the best 84% accuracies for predicting PFS at 6 months (p = 0.02). These static PET parameters were also independent predictor of PFS in multivariate analysis (p ≤ 0.05).

Conclusion

In HGG patients having undergone a Stupp protocol, the absence of significant PET uptake after TMZ constitutes a favorable prognostic factor.