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STATISTICAL RISK ANLAYSIS FOR CLINICAL OUTCOMES USING MID-THERAPY FDG PET IN SARCOMA PATIENTS

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STATISTICAL RISK ANLAYSIS FOR CLINICAL OUTCOMES USING MID-THERAPY FDG PET IN SARCOMA PATIENTS - PowerPoint PPT Presentation


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Janet Eary 1 , Janet O\'Sullivan 3 , Finbarr O\'Sullivan 3 , E. U. Conrad 2 1. Nuclear Medicine/Radiology, University of Washington, Seattle, WA, United States. 2. Orthopedics, University of Washington, Seattle, WA, United States. 3. Statistics, University College Cork, Cork, Ireland.

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Janet Eary1, Janet O\'Sullivan3, Finbarr O\'Sullivan3, E. U. Conrad21. Nuclear Medicine/Radiology, University of Washington, Seattle, WA, United States. 2. Orthopedics, University of Washington, Seattle, WA, United States. 3. Statistics, University College Cork, Cork, Ireland

STATISTICAL RISK ANLAYSIS

FOR CLINICAL OUTCOMES USING MID-THERAPY FDG PET IN SARCOMA PATIENTS

uw soft tissue sarcoma treatment protocol
UW Soft Tissue Sarcoma Treatment Protocol
  • Large Intermediate and High grade Tumors
  • pre-resection 4 chemotherapy cycles
  • Tumor resection
  • 4 additional cycles of chemotherapy
  • 3 FDG PET scans to monitor response
slide3

2-fluoro-2-deoxy-D-glucose

18FDG is the most important PET procedure

  •  FDG reflects altered tissue metabolism

More than just “grading” images.

study design analysis
: Study : Design : Analysis :
  • Aims: determine the value of the mid-therapy FDG PET scan for risk assessment for outcome
  • Hypothesis: the mid-therapy FDG PET scan will add predictive value to outcome prediction
  • Methods:

Prospective study

Univariate, and multivariate analyses with Cox proportional Hazards analysis, and models for variables for data reduction

Creation of clinical risk scenarios for different sets of clinical variable combinations

survival reduced model
Survival (reduced model)

Progression-free Survival

Local Progression-free Survival

Overall Survival

survival risk multivariate model
Survival Risk (multivariate model)

Truncal tumors

Extremity tumors

fdg pet risk assessment in sarcoma
FDG PET Risk Assessment in Sarcoma

Conclusions:

  • The mid-therapy scan provides additional information for risk assessment based on FDG PET and clinical variables
  • In addition to overall and progression-free survival, local recurrence risk can be assessed
  • Reduced Hazards and multivariate models for risk assessments provide clinically useful data on an individual patient.

Future Directions:

  • Comparison/inclusion of other risk assessment models into these analysis results
  • Descriptions of tumor subtype and specific responses to therapy types.
  • Use of tumor image regional analysis to assess areas at risk for local recurrence and metastases
progression free survival multivariate model
Progression-free Survival(Multivariate model)

Truncal Tumors

Extremity Tumors

survival risk
Survival Risk

Survival- extremity tumors

Survival- truncal tumors

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