A prospective evaluation of the impact of 18-F-fluoro-deoxy-D-glucose positron emission tomography staging on survival for patients with locally advanced esophageal cancer
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC (United States)
- Department of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC (United States)
- Division of Gastroenterology, Wake Forest University School of Medicine, Winston Salem, NC (United States)
- Division of Medical Oncology, Wake Forest University School of Medicine, Winston Salem, NC (United States)
- Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Winston Salem, NC (United States)
- Division of Nuclear Medicine, Wake Forest University School of Medicine, Winston Salem, NC (United States)
- Department of Surgery, Wake Forest University School of Medicine, Winston Salem, NC (United States)
Purpose: To determine the impact of 18-F-fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) in the staging and prognosis of patients with locally advanced esophageal cancer (LAEC). Methods and Materials: Between January 2000 and October 2004, all patients with LAEC evaluated in the Department of Radiation Oncology were considered for enrollment into a Phase II trial of preoperative chemoradiation. Entry required a staging whole-body FDG-PET scan. Results: One hundred ten consecutive patients were evaluated; 38 were ineligible for reasons including treatment elsewhere, prior malignancy, or refusal of treatment. After conventional staging (clinical examination, endoscopic ultrasound, and chest/abdominal computerized tomography), 33 patients were ineligible because of metastatic disease or poor performance status. Of the remaining 39 patients, 23 were confirmed to have LAEC after FDG-PET staging and were treated in the Phase II trial (Cohort I). Sixteen patients, however, had FDG-PET findings consistent with occult metastatic disease and were deemed ineligible for the trial but were treated with curative intent (Cohort II). The 2-year survival rate for the 23 patients in Cohort I was 64%, compared with 17% (p = 0.003) for patients in Cohort II (FDG-PET positive). Conclusions: More than one-third of patients determined to have LAEC with conventional staging were upstaged with the use of FDG-PET. Despite comparable therapy, upstaging with FDG-PET predicts poor 2-year survival.
- OSTI ID:
- 20793304
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 64, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2005.07.959; PII: S0360-3016(05)02207-8; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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