Original Title: Indicaciones y recomendaciones de uso de PET-CT en planificación de tratamiento de oncología radioterápica. Revisión sistemática

Authors' objectives: Analyse the role of PET-CT in the planning of radiation oncology treatments in different anatomical locations.

Authors' results and conclusions: A total of 510 articles were found in the different sources of information, of which the large majority (472) did not comply with the inclusion criteria. According to locations, the largest number of articles corresponded to the head-neck and lung. The referred results were subrogated. The quality of the evidence was average or low. Only two guidelines or standards included planning with PET-CT. The survey was answered by 52 centres that indicated a need for use (90 %), a low-level of control and an initial study in locations such as lung, head-neck and oesophagus. The level of access was medium and the systems were not automated. CONCLUSIONS The use of data deriving from the PET must be based on a clear understanding of the interpretation and limitations of the functional signal. It is necessary to establish monitoring studies in order to determine the true utility of the PET in radiotherapy planning and its impact on different anatomical locations. It is not sufficient to define that the target areas to X-ray are clearly different in existing studies. It involves subrogated results that must be corroborated in studies that consider the end results in terms of morbidity and mortality. Protocols have yet to be developed for the implementation of this technique and the end results must be defined on the basis of correctly designed clinical tests. The level of use of the technique in Spain is average-to-high. It is being introduced at this time and the way this is to be transformed into protocols has yet to be established. The collaboration of scientific societies would be required to develop the recommendations and protocols used to determine the indication and way in which it is to be utilised.

Authors' methods: An overview was carried out through a critical analysis of experimental studies, protocols, guidelines, recommendations and standards of use of PET-CT in the planning of radiotherapy treatments. The following databases were consulted: MEDLINE, EMBASE, LILACS, Cochrane, CRD and NGC; and the websites of the following companies: ACR, AERO, ASTRO, ESGO, ESMO, ESTRO, IARC, ISRO and SEOR. The text words used were as follows: PET-CT, linear accelerator, radiation therapy, planning. The restraints were as follows: human subjects, 1995-2009 (April). A manual search of the grey literature was made. These text word terms were converted into controlled language and the application of Boolean data. Experimental studies consisting mainly of controlled and randomised clinical tests, meta-analysis and systematic reviews, as well as controlled and uncontrolled prospective observational studies, were included, comprising adult patients who had been subjected to radiotherapy treatment solely with PET-CT planning or in comparison with a CT planning. Likewise, a survey was carried out in order to determine the level of use and transformation into protocols of PET-CT in the Radiation Oncology services of the National Health System (SNS).

Project Status: Completed

Year Published: 2012

URL for published report: https://www.euskadi.eus/contenidos/informacion/2013_osteba_publicacion/es_def/adjuntos/D_13_03%20Pet-Tc%20oncologia%20radioterapica.pdf

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government