Abstract
The aim of this prospective investigation was to assess the association of 18F-FDG PET/CT with time to hormonal treatment failure (THTF) in men with metastatic castrate-sensitive prostate cancer (mCSPC). Methods: 76 men with mCSPC recruited from 2005-2011 underwent 18F-FDG PET/CT and were followed prospectively for THTF, defined as treatment change to chemotherapy or death. Patients who had not switched to chemotherapy were censored at the last follow-up date (median of 36 months, range 12-108 months). Cox regression analyses were performed to examine the association between PET/CT measurements: sum of SUVmax, maximum of SUVmax, and average of SUVmax of up to 10 of the most active lesions and THTF. Survival probabilities were based on the Kaplan-Meier method. Results: 43 patients had hormonal treatment failure and 8 died without documented treatment failure. Median THTF was 26.5 months (95% CI: 15.5-46.6 months). The THTF-free probability at 5 years was 35%+/-6%. In univariate analysis, all PET parameters including number of lesions were statistically significant for THTF. In a reduced multivariate model accounting for clinical variables, only sum of SUVmax (HR 1.01, 95% CI: 1.002-1.03, P = 0.024) and number of lesions (HR 1.18, 95% CI: 1.08-1.29, p<0.001) were independently associated with THTF. When sum of SUVmax was grouped into quartile ranges, there was significantly worse survival probability for patients in the 4th quartile range compared to the 1st, with a univariate hazard ratio of 6.2 (95% CI: 2.8-13.6, p<0.001). Conclusion: Sum of SUVmax and number of lesions derived from 18F-FDG PET/CT provides independent prognostic information on THTF in men with mCSPC.
- Copyright © 2019 by the Society of Nuclear Medicine and Molecular Imaging, Inc.