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Prognostic impact of pretreatment FDG PET parameters in locally advanced cervical cancer treated with concomitant chemoradiotherapy: A systematic review and meta-analysis
  • +5
  • Lu Han,
  • Qi Wang,
  • Lanbo Zhao,
  • Kailu Zhang,
  • Yiran Wang,
  • Xue Feng,
  • Yuliang Zou,
  • Qiling Li
Lu Han
the First Affiliated Hospital of Xi’an Jiaotong University
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Qi Wang
Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Lanbo Zhao
Xi'an Jiaotong University
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Kailu Zhang
the First Affiliated Hospital of Xi’an Jiaotong University
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Yiran Wang
the First Affiliated Hospital of Xi’an Jiaotong University
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Xue Feng
the First Affiliated Hospital of Xi’an Jiaotong University
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Yuliang Zou
Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Qiling Li
Xian Jiaotong University
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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.

Peer review status:UNDER REVIEW

15 Oct 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
16 Oct 2020Assigned to Editor
16 Oct 2020Submission Checks Completed
22 Oct 2020Reviewer(s) Assigned
29 Oct 2020Review(s) Completed, Editorial Evaluation Pending