Predictive Value of 18-Fluoro-Deoxy-Glucose-Positron Emission Tomography (18F-FDG-PET) in the Identification of Responders to Chemoradiation Therapy for the Treatment of Locally Advanced Esophageal Cancer
| Autor: | Tim Oaks, Girish Mishra, James Lovato, Susan A. Melin, A. William Blackstock, Edward A. Levine, Coty Ho, M.R. Farmer, Paige B. Clark, Kim R. Geisinger |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Esophageal Neoplasms Locally advanced Adenocarcinoma 18f fdg pet Fluorodeoxyglucose F18 Predictive Value of Tests medicine Humans Prospective Studies Aged 80 and over medicine.diagnostic_test business.industry Esophageal disease Radiotherapy Dosage Original Articles Esophageal cancer medicine.disease Combined Modality Therapy Predictive value Neoadjuvant Therapy Esophagectomy Positron emission tomography Positron-Emission Tomography Concomitant Carcinoma Squamous Cell Female Surgery Radiopharmaceuticals Nuclear medicine business Chemoradiotherapy |
| Zdroj: | Annals of Surgery. 243:472-478 |
| ISSN: | 0003-4932 |
| Popis: | To evaluate the utility of F-FDG-PET in predicting response to concomitant chemoradiation in locally-advanced esophageal cancer.Approximately 25% of esophageal cancer patients experience a pathologic complete response (pCR) to preoperative chemoradiation therapy. Computed tomography, endoscopy, and endoscopic ultrasound are unable to identify patients experiencing a pCR. Growing evidence supports the use of F-FDG-PET in the staging of esophageal cancer in its ability to detect occult metastatic and lymph nodal disease. The identification of patients with a pCR to chemoradiation could potentially spare those patients the morbidity associated with a resection.Eligibility criteria included T3-T4N0M0 or T1-T4N1M0 esophageal cancer. Patients underwent an initial F-FDG-PET before treatment and then repeated 4 to 6 weeks after chemoradiation, prior to the esophagectomy. Chemoradiation consisted of: cisplatinum, 5-fluorouracil, and radiation to a median dose of 50.4 Gy. Pathologic response was determined from a systematic review of the esophagectomy specimens.Sixty-four patients have completed therapy to date. Response was as follows: pCR 27%, pathologic residual microscopic (pCRmicro) 14.5%, partial response 19%, and stable or progressive disease 39.5%. A pretreatment standardized uptake value (SUVmax1hour)or = 15 was associated with an observed 77.8% significant response (pCR + pCRmicro) compared with 24.2% for patients with a pretreatment SUVmax1hour15 (P = 0.005). Significant response was observed in 71.4% of patients with a decrease in SUVmax1houror = 10 compared with 33.3% when the SUVmax1hour decreased10 (P = 0.004).Pretreatment and posttreatment F-FDG-PET can be useful for predicting significant response to chemoradiation in esophageal cancer. These data should be considered in evaluation of patients for esophagectomy after chemoradiation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|