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In Reply: Dr Oxnard poses an interesting question concerning our study. The general issue of posttherapy evaluation of treatment response and its timing are applicable to all tumor types. Clinically, the reference standard of complete treatment response for solid tumors is a pathologically negative tumor biopsy. Positive tumor biopsies, serum tumor markers, and imaging studies may indicate the presence of disease. However, even if 1 of these studies is positive in the immediate posttherapy period, it is not always indicative of ultimate clinical disease progression.

It was not the goal of our study to compare new or persistent FDG uptake on the 3-month follow-up FDG-PET with tumor biopsy. With the exception of the posttherapy FDG-PET, no additional procedures or interventions were included in our study design. The definition of disease progression in our study was clinical disease recurrence that was ultimately biopsy-proven in 50% of the cases; in the remainder, . . . [Full Text of this Article]

Julie K. Schwarz, MD, PhD; Barry A. Siegel, MD; Farrokh Dehdashti, MD; Perry W. Grigsby, MD, MS
pgrigsby@wustl.edu
Washington University School of Medicine
St Louis, Missouri

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RELATED LETTER

False-Positive Rate of Posttherapy Positron Emission Tomography in Cervical Cancer
Geoffrey R. Oxnard
JAMA. 2008;299(8):898.
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