A PET/CT szerepe a sugárkezelésre kerülő betegek N és M klinikai stagingjében, a terápia meghatározásában Intézeti tapasztalatok

Translated title of the contribution: The predictive role of PET/CT imaging in clinical N and M staging and treatment decision process: Institutional experiences in Hungary

Kovács Arpád, Sipos Dávid, Lukács Gábor, Tóth Zoltán, Vecsera Tímea, Kedves András, Cselik Zsolt, Pandur Attila András, Bajzik Gábor, I. Repa, Hadjiev Janaki

Research output: Contribution to journalArticle

Abstract

Introduction and aim: The aim of our study was to investigate changes in clinical staging N (lymph node) and M (distant metastasis) in patients who receive PET/CT-based 3D radiotherapy within complex oncological treatment, and compare to conventional cross-sectional imaging staging technique. We also investigated the presence of PET/ CT-detected second tumors and the effect of PET/CT on therapeutic decisions. Method: From the 1st of January 2015 to the 30th of November 2016, 192 patients (n = 192) were treated with PET/CT-based radiation (109 head, 44 lung, 28 rectum and 11 cervical localization) in the Oncoradiology Institute of the Health Center of the University of Kaposvár. All patients received conventional cross-sectional and PET/CT imaging in accordance with the valid investigation protocol. The average time interval between the two cross-sectional investigations was 5.2 weeks. Clinical N and M staging was performed on the basis of the classification of the American Joint Committee on Cancer (AJCC) and the Union of International Cancer Control (UICC). Results: By analyzing the clinical stages N and M separately, based on the results of the PET/CT studies, the N stage was changed in 77 cases and the M stage changed in 31 cases. Overall, the PET/CT study resulted in higher clinical stages in 68 (35.4%) patients and lower clinical stages in 14 (7.3%) patients. The treatment plan was changed in 9% of the patients (n = 18) (definitive versus palliative treatment) and the extension of radiotherapy treatment target volume (PTV) was indicated in 20% of the patients (n = 39) due to the change in clinical lymph node status. PET/CT also detected secondary tumors in 15 (8%) patients. Conclusion: Based on our results, the addition of PET/CT to conventional cross-sectional staging imaging permits a more accurate clinical classification of N and M stages and significantly influences therapeutic decisions. PET/CT imaging also provides a great help in detecting occult second tumors. The results of our Institute harmonize with the international data available in the literature.

Original languageHungarian
Pages (from-to)1593-1601
Number of pages9
JournalOrvosi Hetilap
Volume159
Issue number39
DOIs
Publication statusPublished - Sep 1 2018

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Hungary
Therapeutics
Neoplasms
Radiotherapy
Lymph Nodes
Palliative Care
Rectum
Head
Radiation
Neoplasm Metastasis
Lung
Health

ASJC Scopus subject areas

  • Medicine(all)

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A PET/CT szerepe a sugárkezelésre kerülő betegek N és M klinikai stagingjében, a terápia meghatározásában Intézeti tapasztalatok. / Arpád, Kovács; Dávid, Sipos; Gábor, Lukács; Zoltán, Tóth; Tímea, Vecsera; András, Kedves; Zsolt, Cselik; András, Pandur Attila; Gábor, Bajzik; Repa, I.; Janaki, Hadjiev.

In: Orvosi Hetilap, Vol. 159, No. 39, 01.09.2018, p. 1593-1601.

Research output: Contribution to journalArticle

Arpád, K, Dávid, S, Gábor, L, Zoltán, T, Tímea, V, András, K, Zsolt, C, András, PA, Gábor, B, Repa, I & Janaki, H 2018, 'A PET/CT szerepe a sugárkezelésre kerülő betegek N és M klinikai stagingjében, a terápia meghatározásában Intézeti tapasztalatok', Orvosi Hetilap, vol. 159, no. 39, pp. 1593-1601. https://doi.org/10.1556/650.2018.31207
Arpád, Kovács ; Dávid, Sipos ; Gábor, Lukács ; Zoltán, Tóth ; Tímea, Vecsera ; András, Kedves ; Zsolt, Cselik ; András, Pandur Attila ; Gábor, Bajzik ; Repa, I. ; Janaki, Hadjiev. / A PET/CT szerepe a sugárkezelésre kerülő betegek N és M klinikai stagingjében, a terápia meghatározásában Intézeti tapasztalatok. In: Orvosi Hetilap. 2018 ; Vol. 159, No. 39. pp. 1593-1601.
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abstract = "Introduction and aim: The aim of our study was to investigate changes in clinical staging N (lymph node) and M (distant metastasis) in patients who receive PET/CT-based 3D radiotherapy within complex oncological treatment, and compare to conventional cross-sectional imaging staging technique. We also investigated the presence of PET/ CT-detected second tumors and the effect of PET/CT on therapeutic decisions. Method: From the 1st of January 2015 to the 30th of November 2016, 192 patients (n = 192) were treated with PET/CT-based radiation (109 head, 44 lung, 28 rectum and 11 cervical localization) in the Oncoradiology Institute of the Health Center of the University of Kaposv{\'a}r. All patients received conventional cross-sectional and PET/CT imaging in accordance with the valid investigation protocol. The average time interval between the two cross-sectional investigations was 5.2 weeks. Clinical N and M staging was performed on the basis of the classification of the American Joint Committee on Cancer (AJCC) and the Union of International Cancer Control (UICC). Results: By analyzing the clinical stages N and M separately, based on the results of the PET/CT studies, the N stage was changed in 77 cases and the M stage changed in 31 cases. Overall, the PET/CT study resulted in higher clinical stages in 68 (35.4{\%}) patients and lower clinical stages in 14 (7.3{\%}) patients. The treatment plan was changed in 9{\%} of the patients (n = 18) (definitive versus palliative treatment) and the extension of radiotherapy treatment target volume (PTV) was indicated in 20{\%} of the patients (n = 39) due to the change in clinical lymph node status. PET/CT also detected secondary tumors in 15 (8{\%}) patients. Conclusion: Based on our results, the addition of PET/CT to conventional cross-sectional staging imaging permits a more accurate clinical classification of N and M stages and significantly influences therapeutic decisions. PET/CT imaging also provides a great help in detecting occult second tumors. The results of our Institute harmonize with the international data available in the literature.",
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T1 - A PET/CT szerepe a sugárkezelésre kerülő betegek N és M klinikai stagingjében, a terápia meghatározásában Intézeti tapasztalatok

AU - Arpád, Kovács

AU - Dávid, Sipos

AU - Gábor, Lukács

AU - Zoltán, Tóth

AU - Tímea, Vecsera

AU - András, Kedves

AU - Zsolt, Cselik

AU - András, Pandur Attila

AU - Gábor, Bajzik

AU - Repa, I.

AU - Janaki, Hadjiev

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Introduction and aim: The aim of our study was to investigate changes in clinical staging N (lymph node) and M (distant metastasis) in patients who receive PET/CT-based 3D radiotherapy within complex oncological treatment, and compare to conventional cross-sectional imaging staging technique. We also investigated the presence of PET/ CT-detected second tumors and the effect of PET/CT on therapeutic decisions. Method: From the 1st of January 2015 to the 30th of November 2016, 192 patients (n = 192) were treated with PET/CT-based radiation (109 head, 44 lung, 28 rectum and 11 cervical localization) in the Oncoradiology Institute of the Health Center of the University of Kaposvár. All patients received conventional cross-sectional and PET/CT imaging in accordance with the valid investigation protocol. The average time interval between the two cross-sectional investigations was 5.2 weeks. Clinical N and M staging was performed on the basis of the classification of the American Joint Committee on Cancer (AJCC) and the Union of International Cancer Control (UICC). Results: By analyzing the clinical stages N and M separately, based on the results of the PET/CT studies, the N stage was changed in 77 cases and the M stage changed in 31 cases. Overall, the PET/CT study resulted in higher clinical stages in 68 (35.4%) patients and lower clinical stages in 14 (7.3%) patients. The treatment plan was changed in 9% of the patients (n = 18) (definitive versus palliative treatment) and the extension of radiotherapy treatment target volume (PTV) was indicated in 20% of the patients (n = 39) due to the change in clinical lymph node status. PET/CT also detected secondary tumors in 15 (8%) patients. Conclusion: Based on our results, the addition of PET/CT to conventional cross-sectional staging imaging permits a more accurate clinical classification of N and M stages and significantly influences therapeutic decisions. PET/CT imaging also provides a great help in detecting occult second tumors. The results of our Institute harmonize with the international data available in the literature.

AB - Introduction and aim: The aim of our study was to investigate changes in clinical staging N (lymph node) and M (distant metastasis) in patients who receive PET/CT-based 3D radiotherapy within complex oncological treatment, and compare to conventional cross-sectional imaging staging technique. We also investigated the presence of PET/ CT-detected second tumors and the effect of PET/CT on therapeutic decisions. Method: From the 1st of January 2015 to the 30th of November 2016, 192 patients (n = 192) were treated with PET/CT-based radiation (109 head, 44 lung, 28 rectum and 11 cervical localization) in the Oncoradiology Institute of the Health Center of the University of Kaposvár. All patients received conventional cross-sectional and PET/CT imaging in accordance with the valid investigation protocol. The average time interval between the two cross-sectional investigations was 5.2 weeks. Clinical N and M staging was performed on the basis of the classification of the American Joint Committee on Cancer (AJCC) and the Union of International Cancer Control (UICC). Results: By analyzing the clinical stages N and M separately, based on the results of the PET/CT studies, the N stage was changed in 77 cases and the M stage changed in 31 cases. Overall, the PET/CT study resulted in higher clinical stages in 68 (35.4%) patients and lower clinical stages in 14 (7.3%) patients. The treatment plan was changed in 9% of the patients (n = 18) (definitive versus palliative treatment) and the extension of radiotherapy treatment target volume (PTV) was indicated in 20% of the patients (n = 39) due to the change in clinical lymph node status. PET/CT also detected secondary tumors in 15 (8%) patients. Conclusion: Based on our results, the addition of PET/CT to conventional cross-sectional staging imaging permits a more accurate clinical classification of N and M stages and significantly influences therapeutic decisions. PET/CT imaging also provides a great help in detecting occult second tumors. The results of our Institute harmonize with the international data available in the literature.

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KW - Planning

KW - Radiotherapy

KW - Staging

KW - TNM

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