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Novikov SN, Krivorotko P, Bryantseva Z, Akulova I, Emelyanov A, Mortada V, Ponomareva O, Krzhivitskiy P, Kanaev S. Different approaches to target volume definition and boost delivery in surgery de-escalation clinical trial in breast cancer patients with pathological complete response. Radiat Oncol J 2023; 41:267-273. [PMID: 38185931 PMCID: PMC10772592 DOI: 10.3857/roj.2023.00528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 01/09/2024] Open
Abstract
PURPOSE We evaluate various approaches to target volume definition and boost delivery in patients with complete response to neoadjuvant systemic therapy (NST) who were treated by radiotherapy without a surgery. MATERIALS AND METHODS A pathological complete response (pCR) was diagnosed in 21 of 27 patients included in "surgery de-escalation" prospective observation study. Clips were placed in the primary tumor volume (PrTV) before NST and during the vacuum aspiration biopsy. Twenty patients with pCR underwent the whole breast irradiation and a boost to the PrTV. High-dose rate brachytherapy (HDRB) was the basic technique for boost delivery. Finally, we identified the value of fused images (computed tomography [CT] before NST with simulation CT), clips and their combination for an accurate boost delivery. RESULTS A complete overlap between PrTV on pre-treatment CT with the localization of the clips on simulation CT was mentioned in 10, partial mismatch in three patients. In 12 of these 13 women, HDRB was successfully used for the boost delivery. In five cases we mentioned a marked discrepancy between the PrTV on fused images and the topography of the clips. In other two women we did not find clips on simulation CT. The fused images in five of these seven patients showed anatomical landmarks (scar, fibrosis) used for identification of the gross tumor volume. In all 20 women with pCR (average follow-up of 16.6 months), there were no locoregional recurrences. CONCLUSION Combination of the clips with fusion of pre-NST and simulation CTs is important for an accurate boost delivery.
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Affiliation(s)
- Sergey Nikolaevich Novikov
- Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Petr Krivorotko
- Department of Breast Surgery, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Zhanna Bryantseva
- Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Irina Akulova
- Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Alexander Emelyanov
- Department of Breast Surgery, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Viktoria Mortada
- Department of Breast Surgery, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Olga Ponomareva
- Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Pavel Krzhivitskiy
- Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
| | - Sergey Kanaev
- Department of Radiation Oncology and Nuclear Medicine, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia
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Wu F, Huang Y, Huang X, Fang S, Huang X, Huang X, Zhang Z, Shao Z. 99mTc-MIBI Scintigraphy for the Preoperative Assessment of Histological Response to Neoadjuvant Chemotherapy in Patients With Osteosarcoma: A Systematic Review and a Bivariate Meta-Analysis. Front Oncol 2020; 10:762. [PMID: 32528883 PMCID: PMC7258398 DOI: 10.3389/fonc.2020.00762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/21/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose: There have been many attempts to preoperatively evaluate the chemotherapy response of osteosarcoma patients using 99mTc-MIBI scintigraphy. However, the evaluations were lacking in consistency. We performed this systematic review and meta-analysis to systematically evaluate the ability of 99mTc-MIBI scintigraphy in preoperatively assessing the response of osteosarcoma patients to neoadjuvant chemotherapy. Methods: For this systematic review and meta-analysis, PubMed, Web of Science, OVID, the Cochrane Library, and CNKI were searched. Eligible studies were included based on the defined criteria. The index test was 99mTc-MIBI scintigraphy, the reference standard was tumor necrosis rate. Quality Assessment of Diagnostic Accuracy Studies-2 was adopted for quality assessment of included studies. The statistical pooling analysis, meta-regression analysis, subgroup analysis, sensitivity analysis, and publication bias of our research were performed using STATA 15. Results: Eight articles with 189 osteosarcoma patients were included in this systematic review and meta-analysis. Our results demonstrated that the threshold effect of our meta-analysis was significant. The uptake change ratio of 99mTc-MIBI scintigraphy had a pooled sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio, and the area under curve of 0.98 (0.58-1.00), 0.68 (0.47-0.84), 3.1 (1.7-5.5), 0.03 (0.00-0.90), 103 (4-3,003), and 0.91 (0.88-0.93) in preoperative assessment of response of osteosarcoma patients to neoadjuvant chemotherapy. Meta-regression analysis and subgroup analysis indicated the factors of method and cut off value may introduce the heterogeneity. The pooled sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio, and the area under curve of washout rate of 99mTc-MIBI were 0.87 (0.69-0.95), 0.91 (0.75-0.97), 9.3 (3.2-27.0), 0.15 (0.06-0.37), 64 (14-301), and 0.89 (0.86-0.92), respectively. Sensitivity analysis and publication bias demonstrated our meta-analysis was reliable. Conclusion: Both the ΔUR and WR derived from 99mTc-MIBI scintigraphy were valuable in preoperatively assessing the response of osteosarcoma patients to neoadjuvant chemotherapy, and ΔUR may possess a more outstanding diagnostic accuracy than WR.
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Affiliation(s)
- Fashuai Wu
- Department of Orthopaedics, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Huang
- Department of Otorhinolaryngology, The Third Hospital of Wuhan City, Wuhan, China
| | - Xin Huang
- Department of Orthopaedics, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Silang Fang
- Department of Orthopaedics, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohui Huang
- Department of Orthopaedics, The Qichun People's Hospital, Qichun, China
| | - Xin Huang
- Department of Orthopaedics, Tongji Medical College, Union Jiangbei Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhicai Zhang
- Department of Orthopaedics, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zengwu Shao
- Department of Orthopaedics, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
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Collarino A, de Koster EJ, Valdés Olmos RA, de Geus-Oei LF, Pereira Arias-Bouda LM. Is Technetium-99m Sestamibi Imaging Able to Predict Pathologic Nonresponse to Neoadjuvant Chemotherapy in Breast Cancer? A Meta-analysis Evaluating Current Use and Shortcomings. Clin Breast Cancer 2018; 18:9-18. [DOI: 10.1016/j.clbc.2017.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/19/2017] [Accepted: 06/21/2017] [Indexed: 01/01/2023]
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Fernandes RS, de Aguiar Ferreira C, Soares DCF, Maffione AM, Townsend DM, Rubello D, de Barros ALB. The role of radionuclide probes for monitoring anti-tumor drugs efficacy: A brief review. Biomed Pharmacother 2017; 95:469-476. [PMID: 28865367 DOI: 10.1016/j.biopha.2017.08.079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 08/17/2017] [Accepted: 08/20/2017] [Indexed: 02/06/2023] Open
Abstract
Despite recent advances in the development of new therapeutic agents and diagnostic imaging modalities, cancer is still one of the main causes of death worldwide. A better understanding of the molecular signature of cancer has promoted the development of a new generation of anti-cancer drugs and diagnostic agents that specifically target molecular components such as genes, ligands, receptors and signaling pathways. However, intrinsic heterogeneity of tumors has hampered the overall success of target therapies even among patients with similar tumor types but unpredictable different responses to therapy. In this sense, post-treatment response monitoring becomes indispensable and nuclear medicine imaging modalities could provide the tools for an early indication of therapeutic efficacy. Herein, we briefly discuss the current role of PET and SPECT imaging in monitoring cancer therapy together with an update on the current radiolabeled probes that are currently investigated for tumor therapy response assessment.
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Affiliation(s)
- Renata Salgado Fernandes
- Laboratório de radioisótopos, Departamento de análises Clinicas, Universidade Federal de Minas Gerais (UFMG), Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil
| | | | - Daniel Cristian Ferreira Soares
- Laboratório de Bioengenharia, Universidade Federal de Itajubá (UNIFEI), Rua Irmã Ivone Drumond, 200, Itabira, Minas Gerais, Brazil
| | - Anna Margherita Maffione
- Department of Nuclear Medicine, Radiology, Medical Physics and Clinical Pathology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Danyelle M Townsend
- Department of Drug Discovery and Pharmaceutical Sciences, Medical University of South Carolina, USA
| | - Domenico Rubello
- Department of Nuclear Medicine, Radiology, Medical Physics and Clinical Pathology, Santa Maria della Misericordia Hospital, Rovigo, Italy.
| | - André Luís Branco de Barros
- Laboratório de radioisótopos, Departamento de análises Clinicas, Universidade Federal de Minas Gerais (UFMG), Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil.
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