ESTRO 2023

Session Item

Gynaecological

Session Code: 6014

Session Type: Poster (Digital)

Track: Clinical

The association between PET-CT metabolic parameters, SCCA and survival in cervical cancer patients.

Marcin Miszczyk, Poland

Presentation Number: PO-1417

Abstract

Abstract Title:

The association between PET-CT metabolic parameters, SCCA and survival in cervical cancer patients.

Authors:

Marcin Miszczyk¹, Emilia Staniewska¹, Karolina Grudzień², Katarzyna Raczek-Zwierzycka¹, Justyna Rembak-Szynkiewicz³, Andrea d’Amico⁴, Damian Borys⁴, Zuzanna Nowicka⁵, Matylda Sobczak⁵, Katarzyna Płoszka⁵, Magdalena Stankiewicz⁶, Rafał Tarnawski¹

¹Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland, IIIrd Department of Radiotherapy and Chemotherapy, Gliwice, Poland; ²Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland, Radiotherapy Department, Gliwice, Poland; ³Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland, Radiology and Diagnostic Imaging Department, Gliwice, Poland; ⁴Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland, Gliwice, Poland; ⁵Medical University of Lodz, Poland, Department of Biostatistics and Translational Medicine, Łódź, Poland; ⁶Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland, Brachytherapy Department, Gliwice, Poland

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Purpose or Objective

To assess the correlation between pretreatment Squamous Cell Carcinoma Antigen (SCCA) and Total Lesion Glycolysis (TLG30) on pretreatment Positron Emission Tomography – Computed Tomography (PET-CT), and to assess the prognostic value of SCCA and TLG30 for survival in patients treated with (chemo)radiotherapy for primary localized cervical cancer.

Material and Methods

This retrospective study included all consecutive cervical cancer patients treated with radical intent at one tertiary institution between 2011 and 2017. Metabolic parameters of the tumour were calculated using MIM Software by standardized method and comprised of standardized uptake value (SUVmax30, SUVmin30, SUVmedian30, SUVmean30, SUVvariance30), metabolic tumour volume (MTV30) and TLG30. Spearman's rank correlation coefficient and Cox proportional hazards regression model were used for the analysis to assess the correlation between pretreatment SCCA and TLG30, and to assess the prognostic value of analyzed parameters.

Results

The final study group consisted of 198 consecutive cervical cancer patients treated with radical intent between 2011 and 2017, with a median age of 57.2 (IQR 48.6-63.2) and median census-based follow-up of 75.8 months (IQR 39.8-104.1). The patients received a combination of external beam radiotherapy (198, 100%), brachytherapy (196, 99%) and concurrent chemotherapy (181, 91%). The 5-year overall survival was 69.2%, and 60.6% of patients were alive at the time of the analysis.

Squamous cell carcinoma antigen (SCCA) expression in serum was significantly associated with TLG30 (R=0.463, p<0.001) (Figure 1). In univariate analysis, SCCA expression increase of 1 ng/ml was associated with HR 1.003 (95% CI 1.001-1.006) for overall survival (p=0.024). However, in multivariate analysis including patient age, tumour histology, FIGO stage, ECOG, haemoglobin concentrations and metabolic parameters from PET (TLG30 and SUVmedian30), the association of SCCA expression with patient survival was not significant (p=0.585).

Conclusion

TLG30 was significantly associated with overall survival, and could improve the accuracy of pretreatment prognostic assessment, in patients treated with radiotherapy for cervical cancer.