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Lazzari R, Cecconi A, Jereczek-Fossa BA, et al. The role of [(18)F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer: experience of the European Institute of Oncology, Milan, Italy. Ecancermedicalscience. 2014;8:405doi: 10.3332/ecancer.2014.409.
Lazzari, R., Cecconi, A., Jereczek-Fossa, B. A., Travaini, L. L., Dell' Acqua, V., Cattani, F., Rizzo, S., Fodor, C., Landoni, F., & Orecchia, R. (2014). The role of [(18)F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer: experience of the European Institute of Oncology, Milan, Italy. Ecancermedicalscience, 8405. https://doi.org/10.3332/ecancer.2014.409
Lazzari, Roberta, et al. "The role of [(18)F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer: experience of the European Institute of Oncology, Milan, Italy." Ecancermedicalscience vol. 8 (2014): 405. doi: https://doi.org/10.3332/ecancer.2014.409
Lazzari R, Cecconi A, Jereczek-Fossa BA, Travaini LL, Dell' Acqua V, Cattani F, Rizzo S, Fodor C, Landoni F, Orecchia R. The role of [(18)F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer: experience of the European Institute of Oncology, Milan, Italy. Ecancermedicalscience. 2014 Mar 05;8:405. doi: 10.3332/ecancer.2014.409. eCollection 2014. PMID: 24688597; PMCID: PMC3963705.
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Ecancermedicalscience. 2014 Mar 05;8:405. doi: 10.3332/ecancer.2014.409. eCollection 2014.

The role of [(18)F]FDG-PET/CT in staging and treatment planning for volumetric modulated Rapidarc radiotherapy in cervical cancer: experience of the European Institute of Oncology, Milan, Italy.

Ecancermedicalscience

Roberta Lazzari, Agnese Cecconi, Barbara A Jereczek-Fossa, Laura Lavinia Travaini, Veronica Dell' Acqua, Federica Cattani, Stefania Rizzo, Cristiana Fodor, Fabio Landoni, Roberto Orecchia

Affiliations

  1. Advanced Radiotherapy Centre, European Institute of Oncology, Milan 20141, Italy.
  2. Advanced Radiotherapy Centre, European Institute of Oncology, Milan 20141, Italy ; University of Milan, Milan 20122, Italy.
  3. Department of Nuclear Medicine, European Institute of Oncology, Milan 20141, Italy.
  4. Medical Physics Division, European Institute of Oncology, Milan 20141, Italy.
  5. Radiology Division, European Institute of Oncology, Milan 20141, Italy.
  6. Cervical Cancer Centre, Division of Gynaecologic Cancer Surgery, European Institute of Oncology, Milan 20141, Italy.

PMID: 24688597 PMCID: PMC3963705 DOI: 10.3332/ecancer.2014.409

Abstract

RATIONALE: to evaluate the role of 18F-fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET) integrated with computer tomography (CT) scan [(18)F]FDG-PET/CT in the staging and target volume definition in Intensity Modulated RapidarcTM Delivery (RA-IMRT) in cervical cancer.

METHODS: From June 2010 to December 2011, 66 patients affected by cervical cancer, candidates for definitive or adjuvant radiochemotherapy, underwent standard staging with CT and magnetic resonance imaging (MRI). All patients underwent [(18)F]FDG-PET/CT in order to exclude distant metastases and to define gross tumor volume (GTV). 40 and 26 patients received exclusive and adjuvant radiotherapy, respectively. RA-IMRT with simultaneous integrated boost (SIB) to the positive disease technique was employed.

RESULTS: [(18)F]FDG-PET/CT has changed the stage, and radiotherapy treatment planning was modified in 25% and 7.7 % of patients that received definitive and adjuvant radiotherapy, respectively. Particularly [(18)F]FDG-PET/CT imaging showed metabolically active tumor in lymph nodes area, therefore the stage and the treatment planning changed for these patients.

CONCLUSIONS: [(18)F]FDG-PET/CT leads to a better staging and definition of disease and has the potential of showing lymph-node metastasis not only within the pelvis but also in the para-aortic area. In addition, [(18)F]FDG-PET/CT is useful for better definition of the target volume and to produce a 'dose painted' treatment. This might also open the field for escalation dose regimens.

Keywords: ([18F]FDG-PET/CT); IMRT; Rapidarc radiotherapy; cervical cancer

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