Abstract
Objective: To determine whether an interim 18 F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride ( 223 RaCl 2 ) therapy is able to identify patients that will not respond to treatment. Materials and Methods: We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to 223 RaCl 2 therapy. All of the patients underwent baseline and interim 18 F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of 223 RaCl 2 . The skeletal tumor burden—expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF 10 )—was calculated for the baseline and the interim studies. The percent change in TLF 10 between the baseline and interim studies (%TFL 10 ) was calculated as follows: %TFL 10 = interim TLF 10 − baseline TLF 10 / baseline TLF 10 . End points were overall survival, progression-free survival, and skeletal-related events. Results: The mean age of the patients was 72.4 ± 10.2 years (range, 43.3–88.8 years). The %TLF 10 was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236–2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557–2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399–6.312). Conclusion: The skeletal tumor burden on an interim 18 F-fluoride PET/CT, performed after three cycles of 223 RaCl 2 , is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time.
Original language | English (US) |
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Pages (from-to) | 33-40 |
Number of pages | 8 |
Journal | Radiologia Brasileira |
Volume | 52 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2019 |
Keywords
- Bone neoplasms/diagnostic imaging
- Positron-emission tomography/methods
- Prostatic neoplasms
- Radium-223
- Sodium fluoride
- Tomography,X-ray computed/methods
- Tumor burden
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
MD Anderson CCSG core facilities
- Clinical Trials Office