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Positron
emission tomography (11)C-methionine and survival in patients with
low-grade gliomas
Ribom
D, Eriksson A, Hartman M, Engler H, Nilsson A, Langstrom B, Bolander
H, Bergstrom M, Smits A
Department
of Neuroscience, Neurology, University Hospital, Uppsala, Sweden.
dan.ribom@neurologi.uu.se
Background. Considerable numbers of patients with
low-grade gliomas experience an early malignant course and may benefit
from aggressive treatment.
These
patients are difficult to identify using established prognostic
factors.
A
retrospective study was performed to determine whether the
(11)C-methionine uptake in tumor is a survival factor in adult
patients with supratentorial gliomas classified as World Health
Organization Grade 2.
Methods.
The authors identified 89 patients with histologically confirmed
low-grade gliomas in whom an (11)C-methionine positron emission
tomography (PET) scan had been performed as part of the diagnostic
tumor investigation from 1983 to 1998.
Clinical
data were collected, and the PET scans were re-evaluated according to
a fixed protocol.
The
(11)C-methionine uptake in the tumor and relevant clinical parameters
were entered into univariate and multivariate survival analyses.
Results.
At the end of the study, 49 patients (55.1%) had died.
The
median overall survival was 5.7 years.
Low
methionine uptake was significantly favorable in the multivariate
survival analysis (P = 0.04) along with oligodendroglioma (P =
0.003).
In
the histologic subgroups, (11)C-methionine uptake was an important
survival factor among patients with astrocytomas (P = 0.05) and
oligodendrogliomas (P = 0.03).
Tumor
resection was a favorable prognostic factor in patients with high
methionine uptake (P = 0.01) but not in patients with low
uptake.
Conclusions.
Baseline (11)C-methionine PET is a prognostic indicator in patients
with low-grade gliomas.
The
results imply that PET is a valuable tool in the clinical management
of these patients and may assist in the selection of patients for
therapy.
Copyright
2001 American Cancer Society.
PMID: 11745233 [PubMed - indexed for MEDLINE]
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