Document Detail


Chemotherapy response assessment in stage IV melanoma patients-comparison of 18F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B.
MedLine Citation:
PMID:  18458901     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study aims to compare the use of 18F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B in chemotherapy response assessment of stage IV melanoma patients. METHODS: In 25 patients with stage IV melanoma, FDG-PET/CT and S-100B after 2-3 months (three cycles) of chemotherapy was compared with baseline PET/CT and baseline S-100B. Retrospectively, the response was correlated with the outcome. In patients with clinical suspicion for brain metastases, MRI or CCT was performed. RESULTS: There was agreement between FDG-PET/CT and CT regarding response to chemotherapy in all patients. There was a clear trend to a longer OS of PET/CT responders (n=10) compared with PET/CT non-responders (n=15; p=0.072) with remarkably better 1-year OS of 80% compared to 40% (p=0.048). There was a significant longer PFS of PET/CT responders compared with PET/CT non-responders (p=0.002). S-100B was normal at baseline in eight of 22 patients where it was available. Chemotherapy response assessment with S-100B failed to show correlation with OS or PFS. Eleven patients developed brain metastases during treatment, first detected by PET/CT in two and by MRI or CCT in nine of 11 patients. Appearance of brain metastases was associated with a poor survival. CONCLUSIONS: 18F-FDG-PET/CT and CT alone are equally suitable for chemotherapy response assessment in melanoma patients and clearly superior to S-100B. PET/CT responders have better early survival, but this is shortlived due to late therapy failure--often with brain recurrence. Additional brain MRI for therapy response assessment in such high-risk patients is mandatory to detect brain metastases missed by PET/CT.
Authors:
Klaus Strobel; Reinhard Dummer; Hans C Steinert; Katrin Baumann Conzett; Karin Schad; Marisol Pérez Lago; Jan D Soyka; P Veit-Haibach; Burkhardt Seifert; V Kalff
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-05-06
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  35     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-23     Completed Date:  2009-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1786-95     Citation Subset:  IM    
Affiliation:
Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland. klaus.strobel@usz.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents / therapeutic use*
Brain / pathology*,  radiography*
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Magnetic Resonance Imaging / methods*
Melanoma* / blood,  diagnosis,  drug therapy,  secondary
Middle Aged
Nerve Growth Factors / blood*
Outcome Assessment (Health Care) / methods
Positron-Emission Tomography / methods*
Prognosis
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Retrospective Studies
S100 Proteins / blood*
Sensitivity and Specificity
Subtraction Technique
Survival Analysis
Survival Rate
Tomography, X-Ray Computed / methods*
Treatment Outcome
Tumor Markers, Biological / blood
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Nerve Growth Factors; 0/Radiopharmaceuticals; 0/S-100 calcium-binding protein beta subunit; 0/S100 Proteins; 0/Tumor Markers, Biological; 63503-12-8/Fluorodeoxyglucose F18

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