FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience
AimsRadiotherapy with concurrent 5-fluorouracil/mitomycin-C based chemotherapy has been established as definitive standard therapy approach for anal cancer. Intensity Modulated Radiotherapy (IMRT) leads to a precise treatment of the tumor, allowing dose escalation on Gross Tumor Volume (GTV), with a...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.655322/full |
| _version_ | 1818624221834641408 |
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| author | Clelia Di Carlo Maika di Benedetto Lisa Vicenzi Sara Costantini Francesca Cucciarelli Francesco Fenu Eleonora Arena Cristina Mariucci Maria Montisci Valeria Panni Fabiola Patani Marco Valenti Andrea Palucci Luca Burroni Giovanna Mantello |
| author_facet | Clelia Di Carlo Maika di Benedetto Lisa Vicenzi Sara Costantini Francesca Cucciarelli Francesco Fenu Eleonora Arena Cristina Mariucci Maria Montisci Valeria Panni Fabiola Patani Marco Valenti Andrea Palucci Luca Burroni Giovanna Mantello |
| author_sort | Clelia Di Carlo |
| collection | DOAJ |
| description | AimsRadiotherapy with concurrent 5-fluorouracil/mitomycin-C based chemotherapy has been established as definitive standard therapy approach for anal cancer. Intensity Modulated Radiotherapy (IMRT) leads to a precise treatment of the tumor, allowing dose escalation on Gross Tumor Volume (GTV), with a surrounding healthy tissues sparing. Our study assessed the impact of 18-Fluorodeoxyglucose positron emission tomography (18FDG-PET/CT) on the radiotherapy contouring process and its contribution to lymphatic spread detection, resulting to a personalization of Clinical Target Volume (CTV) and dose prescription.MethodsThirty-seven patients, with histologically proven squamous cell carcinoma of the anal canal (SCCAC) were analyzed. All patients were evaluated with history and physical examination, trans-anal endoscopic ultrasound, pelvis magnetic resonance imaging (MRI), computed tomography (CT) scans of the chest, abdomen and pelvis and planning 18FDG-PET/CT. The GTV and CTV were drawn on CT, MRI and 18FDG-PET/CT fused images.ResultsThirty-four (91%) out of 37 patients presented lymph nodes involvement, in one or more areas, detected on 18FDG-PET/CT and/or MRI. The 18FDG-PET/CT showed positive lymph nodes not detected on MRI imaging (PET+, MRI−) in 14/37 patients (38%). In 14 cases, 18FDG-PET/CT allowed to a dose escalation in the involved nodes. The 18FDG-PET/CT fused images led to change the stage in 5/37(14%) cases: four cases from N0 to N1 (inguinal lymph nodes) and in one case from M0 to M1 (common iliac lymph nodes).ConclusionsThe 18FDG-PET/CT has a potentially relevant impact in staging and target volume delineation/definition in patients affected by anal cancer. In our experience, clinical stage variation occurred in 14% of cases. More investigations are needed to define the role of 18FDG-PET/CT in the target volume delineation of anal cancer. |
| first_indexed | 2024-12-16T18:53:31Z |
| format | Article |
| id | doaj.art-c725b5269c3f4bc790bbc47c8c7d2cb3 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-16T18:53:31Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c725b5269c3f4bc790bbc47c8c7d2cb32022-12-21T22:20:36ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-07-011110.3389/fonc.2021.655322655322FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional ExperienceClelia Di Carlo0Maika di Benedetto1Lisa Vicenzi2Sara Costantini3Francesca Cucciarelli4Francesco Fenu5Eleonora Arena6Cristina Mariucci7Maria Montisci8Valeria Panni9Fabiola Patani10Marco Valenti11Andrea Palucci12Luca Burroni13Giovanna Mantello14Department of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Medical Physics, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Nuclear Medicine, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Nuclear Medicine, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyDepartment of Radiation Oncology, Ospedali Riuniti Umberto I°, GM Lancisi, G Salesi, Ancona, ItalyAimsRadiotherapy with concurrent 5-fluorouracil/mitomycin-C based chemotherapy has been established as definitive standard therapy approach for anal cancer. Intensity Modulated Radiotherapy (IMRT) leads to a precise treatment of the tumor, allowing dose escalation on Gross Tumor Volume (GTV), with a surrounding healthy tissues sparing. Our study assessed the impact of 18-Fluorodeoxyglucose positron emission tomography (18FDG-PET/CT) on the radiotherapy contouring process and its contribution to lymphatic spread detection, resulting to a personalization of Clinical Target Volume (CTV) and dose prescription.MethodsThirty-seven patients, with histologically proven squamous cell carcinoma of the anal canal (SCCAC) were analyzed. All patients were evaluated with history and physical examination, trans-anal endoscopic ultrasound, pelvis magnetic resonance imaging (MRI), computed tomography (CT) scans of the chest, abdomen and pelvis and planning 18FDG-PET/CT. The GTV and CTV were drawn on CT, MRI and 18FDG-PET/CT fused images.ResultsThirty-four (91%) out of 37 patients presented lymph nodes involvement, in one or more areas, detected on 18FDG-PET/CT and/or MRI. The 18FDG-PET/CT showed positive lymph nodes not detected on MRI imaging (PET+, MRI−) in 14/37 patients (38%). In 14 cases, 18FDG-PET/CT allowed to a dose escalation in the involved nodes. The 18FDG-PET/CT fused images led to change the stage in 5/37(14%) cases: four cases from N0 to N1 (inguinal lymph nodes) and in one case from M0 to M1 (common iliac lymph nodes).ConclusionsThe 18FDG-PET/CT has a potentially relevant impact in staging and target volume delineation/definition in patients affected by anal cancer. In our experience, clinical stage variation occurred in 14% of cases. More investigations are needed to define the role of 18FDG-PET/CT in the target volume delineation of anal cancer.https://www.frontiersin.org/articles/10.3389/fonc.2021.655322/fullanal cancer18FDG PET/CTradiotherapy planningdose escalationtarget volume definition |
| spellingShingle | Clelia Di Carlo Maika di Benedetto Lisa Vicenzi Sara Costantini Francesca Cucciarelli Francesco Fenu Eleonora Arena Cristina Mariucci Maria Montisci Valeria Panni Fabiola Patani Marco Valenti Andrea Palucci Luca Burroni Giovanna Mantello FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience Frontiers in Oncology anal cancer 18FDG PET/CT radiotherapy planning dose escalation target volume definition |
| title | FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience |
| title_full | FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience |
| title_fullStr | FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience |
| title_full_unstemmed | FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience |
| title_short | FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience |
| title_sort | fdg pet ct in the radiotherapy treatment planning of locally advanced anal cancer a monoinstitutional experience |
| topic | anal cancer 18FDG PET/CT radiotherapy planning dose escalation target volume definition |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.655322/full |
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