UZH-Logo

Maintenance Infos

Chemotherapy response assessment in stage IV melanoma patients-comparison of (18)F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B


Strobel, K; Dummer, R; Steinert, H C; Baumann Conzett, K; Schad, K; Pérez Lago, M; Soyka, J D; Veit-Haibach, P; Seifert, Burkhardt; Kalff, V (2008). Chemotherapy response assessment in stage IV melanoma patients-comparison of (18)F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B. European Journal of Nuclear Medicine and Molecular Imaging, 35(10):1786-1795.

Abstract

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.

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.

Citations

18 citations in Web of Science®
22 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

125 downloads since deposited on 07 Nov 2008
35 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:October 2008
Deposited On:07 Nov 2008 16:07
Last Modified:05 Apr 2016 12:30
Publisher:Springer
ISSN:1619-7070
Additional Information:The original publication is available at www.springerlink.com.
Publisher DOI:10.1007/s00259-008-0806-1
PubMed ID:18458901
Permanent URL: http://doi.org/10.5167/uzh-4382

Download

[img]
Filetype: PDF - Registered users only
Size: 1MB
View at publisher
[img]
Preview
Content: Accepted Version
Filetype: PDF
Size: 1MB

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations