PET/CT scanning guided intensity-modulated radiotherapy in treatment of recurrent ovarian cancer

Objective

This study was undertaken to evaluate the clinical contribution of positron emission tomography using ¹⁸F-fluorodeoxyglucose and integrated computer tomography (FDG-PET/CT) guided intensity-modulated radiotherapy (IMRT) for treatment of recurrent ovarian cancer.

Materials and methods

Fifty-eight patients with recurrent ovarian cancer from 2003 to 2008 were retrospectively studied. In these patients, 28 received PET/CT guided IMRT (PET/CT–IMRT group), and 30 received CT guided IMRT (CT–IMRT group). Treatment plans, tumor response, toxicities and survival were evaluated.

Results

Changes in GTV delineation were found in 10 (35.7%) patients based on PET–CT information compared with CT data, due to the incorporation of additional lymph node metastases and extension of the metastasis tumor. PET/CT guided IMRT improved tumor response compared to CT–IMRT group (CR: 64.3% vs. 46.7%, P = 0.021; PR: 25.0% vs. 13.3%, P = 0.036). The 3-year overall survival was significantly higher in the PET–CT/IMRT group than control (34.1% vs. 13.2%, P = 0.014).

Conclusions

PET/CT guided IMRT in recurrent ovarian cancer patients improved the delineation of GTV and reduce the likelihood of geographic misses and therefore improve the clinical outcome.