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Identifier

000465585

Title

Εκτίμηση των Α) δεικτών φλεγμονής αίματος, Β) παραμέτρων ιστογράμματος δόσης-όγκου και Γ) μεταβολικών παραμέτρων του 18F-FDGPET/CT, σε ασθενείς που υποβάλλονται σε ριζική σύγχρονη χημειοακτινοθεραπεία για ανεγχείρητο καρκίνο τραχήλου μήτρας .Μπορούν να χρησιμεύσουν ως δυνητικοί προβλεπτικοί βιοδείκτες ανταπόκρισης στη θεραπεία

Alternative Title

Evaluation of A) blood inflammatory markers, B) dose volume histogram parameters and C) metabolic parameters of 18F-FDG- PET/CT, in patients undergoing radical modern chemo-radiotherapy for unoperated cervical cancer. Can they be used as potential predictive biomarkers of treatment response ?

Author

Βουλγαράκη, Δέσποινα

Thesis advisor

Τόλια, Μαρία

Reviewer

Σουγκλάκος, Ιωάννης
Βρεκούσης, Θωμάς

Abstract

Introduction: Cervical cancer is a cancer that infiltrates the cervix tissues. It is the fourth most common cancer in women under the age of 45 years and is one of the leading causes of cancer death in women worldwide. It is mainly caused by infection with the human papilloma virus (HPV) and is classified into four stages facilitating the prognosis and the choice of the appropriate treatment. Aim: In the present study, locally advanced cervical cancer -including stages IB2-IVA- is investigated. More specifically, the correlation of quantitative parameters as potentially predictive biomarkers of response in patients with locally advanced cervical cancer undergoing modern chemo-radiotherapy is tested. Materials and Methods: The parameters evaluated were: a) blood inflammatory markers (CRP, Ferritin, Albumin), b) volume dose histogram data and c) metabolic parameters of (18)F-FDG PET/CT (SUV max). These were measured at two different times, a) before the start of radiotherapy (baseline) and 3 months after the end of radiotherapy. The patients underwent external pelvic radiation therapy or extensive, with newer techniques (3DCRT/IMRT/VMAT), at the Radiation Oncology Department, University General Hospital of Heraklion (PAGNI). The planning of the radiation fields was carried out with the guidance of PET/CT (PET-CT Guided). The total radiotherapy dose was 45-50.4 Gy/1.8 Gy/session. Irradiation was performed on the primary site and the regional infiltrated lymph nodes. In addition, the radiosensitizer cisplatin was administered weekly (40 mg/m2 weekly, for 5 - 6 cycles). Patients also received intraabdominal brachytherapy, based on lower abdominal MRI, after completion of external beam radiotherapy. Results: The results of the present work show that among the parameters evaluated, the mean value of both albumin and ferritin before radiotherapy were not found to be statistically significantly different from the corresponding 3 months after radiotherapy. On the contrary, the mean value of CRP before radiotherapy was found, statistically significantly, higher than the corresponding value 3 months after radiotherapy. The effect size was indeed found to be of great practical importance thus highlighting its highest utility as a predictive biomarker of response. Conclusion: The above data reveal a potentially guiding material that could be considered as a predictive biomarker in the therapeutic management of cervical cancer.

Language

Greek, English

Subject

Predictive biomarkers

SUVMAX

Δείκτες φλεγμονής

Ιστόγραμμα δόσης όγκου

Issue date

2024-07-26

Collection

School/Department--School of Medicine--Department of Medicine--Post-graduate theses

Type of Work--Post-graduate theses