Assessment of Response to Neoadjuvant Chemoradiotherapy by 18F-FDG PET/CT in Patients With Locally Advanced Esophagogastric Junction Adenocarcinoma
| Autor: | Sebastian Casanueva, Maria Mayoral, Mario Pagés, P. Perlaza, Elvira Buxó, Domenico Rubello, David Fuster, N. Sánchez-Izquierdo, Angels Ginès, Patrick M. Colletti, José Ríos, Gloria Fernández-Esparrach |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Adenocarcinoma 030218 nuclear medicine & medical imaging Metastasis 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Survival analysis Neoadjuvant therapy medicine.diagnostic_test business.industry General Medicine Chemoradiotherapy Middle Aged medicine.disease Prognosis Neoadjuvant Therapy Response Evaluation Criteria in Solid Tumors Positron emission tomography 030220 oncology & carcinogenesis Female Radiology Esophagogastric Junction business |
| Zdroj: | Clinical nuclear medicine. 45(1) |
| ISSN: | 1536-0229 |
| Popis: | Purpose The outcome of locally advanced adenocarcinoma of the esophagogastric junction (AEG) treated with preoperative chemoradiotherapy is heterogeneous, and favorable response to this treatment is a key factor in the patient's prognosis. The aim of this study was to evaluate F-FDG PET/CT in assessing metabolic response in patients with AEG. Materials and methods This prospective study evaluated all consecutive patients with potentially operable locally advanced AEG who were candidates for neoadjuvant chemoradiotherapy. PET/CT and contrast-enhanced thoracoabdominal CT were performed at baseline and 2 weeks after completion of chemoradiotherapy for response evaluation. The response rate was assessed using Response Evaluation Criteria in Solid Tumors criteria for contrast-enhanced thoracoabdominal CT and Positron Emission Tomography Response Criteria in Solid Tumors criteria for PET/CT. The regression rate was assessed using a 5-grade histopathology scoring system of the surgically resected tumor. Metastatic lesions were confirmed by histopathology examination or imaging and clinical follow-up at 6 months. Results A total of 40 cases were finally included in the study. Distant metastases were found in the baseline PET/CT in 6 of 40 cases (retroperitoneal [2] or mediastinal/hiliar [1] lymph nodes and liver [2] or bone [1] metastases) and were therefore excluded from surgery. Pathologic response correlated with the ΛSUVmax threshold of ≤45% (P = 0.033). CT response correlated well with both the baseline SUVmax (P = 0.039) and the ΛSUVmax (P = 0.001). Five-year survival curves for AEG correlated with the ΛSUVmax using a threshold of ≤45% for both progression-free and overall survival. Conclusions F-FDG PET/CT is useful for diagnosing nonsuspected metastasis before neoadjuvancy in potentially operable AEG. The ΛSUV correlates with pathologic response and is a long-term independent prognostic factor of survival. |
| Databáze: | OpenAIRE |
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