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Eur J Cancer. 2015 Nov;51(17):2545-52. doi: 10.1016/j.ejca.2015.07.044. Epub 2015 Aug 28.

18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients.

Author information

1
Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
2
Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
3
Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
4
Department of Thoracic Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
5
Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
6
Department of Clinical Pharmacy, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
7
Department of Pathology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
8
Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
9
Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA. Electronic address: jajani@mdanderson.org.

Abstract

INTRODUCTION:

The purpose of this study was to evaluate if a baseline, an interim or a post-chemoradiation (CTRT) 18-fluorodeoxy-glucose positron emission computed tomography (18F-FDG PET/CT) studies could provide information on pathologic response to CTRT and overall survival (OS).

MATERIALS AND METHODS:

Thirty-one patients with histologically proven adenocarcinoma or squamous cell carcinoma of the oesophagus, fit for trimodality therapy were prospectively enrolled. Most were men (93.5%), and had a stage III cancer (74.2%). Chemotherapy consisted of oxaliplatin/5-fluorouracil (45.2%) and taxane/5-fluorouracil (54.8%). All patients underwent a baseline, an interim (performed 12 ± 2 days after the onset of CTRT) and a post-CTRT 18F-FDG PET/CT study. The 18F-FDG PET/CT variables evaluated were at baseline, interim and post-CTRT studies maximum standardised uptake value (SUV max) and total lesion glycolysis (TLG). Clinical and 18F-FDG PET/CT parameters were correlated with pathologic complete response (pathCR) and OS.

RESULTS:

Among the 31 patients studied, 61.3% achieved a clinical complete response (cCR) and 87.1% had surgery. The median OS was 35.1 months (95% confidence interval (CI): 19.9-NA). PathCR rate was 22.2%. There was only a marginal association between cCR and pathCR (p = 0.06). None of the other variables was predictive of pathCR. There was association between OS and baseline TLG (p = 0.03) at the optimal cutoff TLG value of 75.15. Additionally, TLG and ΔTLG post-CTRT were also associated with OS (p = 0.01 and 0.03, respectively).

CONCLUSION:

None of the PET parameters is predictive of pathCR but TLG at baseline and post-CTRT are prognostic of OS.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00833625.

KEYWORDS:

18F-FDG PET/CT; Chemoradiation; Early response evaluation; Gastroesophageal cancer; Pathologic response

PMID:
26321501
PMCID:
PMC4663130
DOI:
10.1016/j.ejca.2015.07.044
[Indexed for MEDLINE]
Free PMC Article

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