• Natalie Charnley, Catharine M West, Carolyn M Barnett, Catherine Brock, Graeme M Bydder, Mark Glaser, Ed S Newlands, Ric Swindell, Julian Matthews, and Pat Price.
• Wolfson Molecular Imaging Centre, Academic Department of Radiation Oncology, The University of Manchester, Christie Hospital NHS Trust, Manchester, United Kingdom. natalie.charnley@mmic.man.ac.uk
• Int. J. Radiat. Oncol. Biol. Phys. 2006 Oct 1; 66 (2): 331-8.

PurposeTo compare the ability of positron emission tomography (PET) to predict response to temozolomide vs. temozolomide plus radiotherapy.Methods And MaterialsNineteen patients with high-grade glioma (HGG) were studied. Patients with recurrent glioma received temozolomide 75 mg/m2 daily for 7 weeks (n=8). Newly diagnosed patients received temozolomide 75 mg/m2 daily plus radiotherapy 60 Gy/30 fractions over 6 weeks, followed by six cycles of adjuvant temozolomide 200 mg/m2/day (Days 1-5 q28) starting 1 month after radiotherapy (n=11). [18F]Fluorodeoxyglucose ([18F]FDG) PET scan and magnetic resonance imaging (MRI) were performed at baseline, and 7 and 19 weeks after initiation of temozolomide administration. Changes in glucose metabolic rate (MRGlu) and MRI response were correlated with patient survival.ResultsIn the temozolomide-alone group, patients who survived>26 vs. or=25%, survived longer than nonresponders with mean survival times of 75 weeks (95% CI, 34-115 vs. 20 weeks (95% CI, 14-26) (p=0.0067). In the small group of patients studied, there was no relationship between MRI response and survival (p=0.52). For patients receiving temozolomide plus radiotherapy, there was no difference in survival between PET responders and nonresponders (p=0.32).ConclusionsEarly changes in MRGlu predict response to temozolomide, but not temozolomide plus radiotherapy.

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