Lu Han

and 7 more

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.