PET-FDG Imaging in Metastatic Breast Cancer Treated with High Dose Chemotherapy and Stem Cell Support

摘要

The purpose of our study was to evaluate the effectiveness of PET-FDG in patients with metastatic breast cancer who were also being treated with high dose chemotherapy and stem cell rescue. The hypotheses of the study were as follow: (1) Active tumor sites shown by anatomical imaging methods will be associated with high levels of metabolic activity while inactive sites will be reflected by low levels of FDG uptake. (2) Reduction in tumor metabolic activity of tumors will be an early predictor of response to high dose chemotherapy. (3) Patients with no abnormal FDG uptake prior to high dose chemotherapy will live longer than patients with tumor that are metabolically active. The use of PET in this setting is potentially cost-saving considering the high costs of stem cell rescue. Non responders do not need to undergo further chemotherapy with consequent suffering and high costs, when palliation is more appropriate. On the other hand, the ability to predict the response to chemotherapy in responders might enable the physician to modulate the treatment for each patient. The study included a homogeneous group of patients entered on two University of Pennsylvania studies for the treatment of breast cancer with high dose chemotherapy. The chemotherapy protocols were protocol UPCC No. 3195 and Protocol PBT-1.