Prognostic impact of pretreatment FDG PET parameters in locally advanced
cervical cancer treated with concomitant chemoradiotherapy: A systematic
review and meta-analysis
Abstract
Background More evidence has shown FDG PET/CT parameters might be
associated with survival of patients with locally advanced cervical
cancer (LACC) treated with concurrent chemo-radiotherapy (CCRT).
Objectives To perform this meta-analysis to investigate the prognostic
value of pretreatment FDG PET/CT parameters. Search strategy PubMed and
Embase. Selection criteria Studies that met the following criteria were
enrolled: patients treated with CCRT for LACC; FDG PET/CT scans
performed before or during treatment; and relationship between the
parameters of FDG PET/CT and the prognosis of patients were
investigated. Data collection and analysis Pooled hazard ratios (HRs)
with 95% confidence intervals (CIs) were used to estimate overall
survival (OS) or event-free survival (EFS). Main results Higher primary
tumor TLG (HR = 1.843, 95% CI = 1.100–3.086, P = 0.02) and MTV (HR =
2.06, 95% CI, 1.21–3.51, P = 0.007) were significantly associated with
shorter EFS. Patients with high SUVmax have a shouter OS than those with
low SUVmax (HR = 2.582, 95% CI 1.936–3.443, P <0.001).
Primary tumor SUVmax (HR = 1.938, 95% CI, 1.203–3.054, P = 0.004) and
nodal SUVmax (HR = 3.478, 95% CI = 2.006-6.029, P <0.001)
were significantly correlated with EFS with relatively high
heterogeneity (I2 = 84%, I2 = 69.4%, respectively). Nodal SUVmax (HR =
2.095, 95% CI = 2.027–2.166, P <0.001) were significantly
correlated with OS with relatively high heterogeneity (I2 = 54.1%, P =
0.140). Other parameters had no detected association with survival.
Conclusions Pretreatment FDG PET/CT parameters serve as a prognostic
predictor.