Correlation of Molecular Response as Measured by 18-FDG Positron Emission Tomography With Outcome After Chemoradiotherapy in Patients with Esophageal Carcinoma

Journal Article · Mon Oct 01 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.03.053· OSTI ID:21036234

Cheng, Jonathan D ^[1]; Goldberg, Melvyn ^[2]; Tianyu, Li ^[3]; Maurer, Alan ^[4]; Yu, Jian Q ^[5]; Haluszka, Oleh ^[6]; Scott, Walter ^[2]; Meropol, Neal J; Cohen, Steven J ^[1]; Freedman, Gary ^[7]; Weiner, Louis M ^[1]

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1. Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
2. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
3. Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States)
4. Department of Nuclear Medicine, Temple University School of Medicine, Philadelphia PA (United States)
5. Department of Radiology, Fox Chase Cancer Center, Philadelphia, PA (United States)
6. Division of Gastroenterology, Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
7. Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)

Purpose: To determine whether 18-fluorodeoxyglucose positron emission tomography (PET) computed tomography scans predict the pathologic complete response and disease-free and overall survival in patients with esophageal carcinoma undergoing definitive or preoperative chemoradiotherapy. Methods and Materials: The records of patients with esophageal carcinoma presenting for definitive or preoperative treatment and undergoing pre- and post-treatment 18-fluorodeoxyglucose PET-computed tomography scans were retrospectively reviewed. The histologic type, T stage, and nodal status were the variables investigated to determine a relationship with the baseline standardized uptake value (SUV) of the primary tumor at diagnosis. We also attempted to determine whether a relationship exists between the percent decrease in SUV and a pathologic complete response, overall and disease-free survival. Results: A total of 81 patients, 14 women and 67 men, underwent 18-fluorodeoxyglucose PET-computed tomography scanning before treatment and 63 also had post-treatment scans. T stage and tumor location predicted in univariate, but not multivariate, analysis for the initial SUV. Of the patients with a postchemoradiotherapy SUV of <2.5, 66% had tumor in the surgical specimen and 64% of patients had positive lymph nodes at surgery that were not imaged on the postchemoradiotherapy PET scan. A trend existed for post-treatment SUV and the days from radiotherapy to surgery to predict for a pathologic complete response (p = 0.09 and p = 0.08, respectively). The post-treatment SUV predicted for disease-free survival in the definitive chemoradiotherapy group (p = 0.01). Conclusions: A correlation was found between the depth of tumor invasion and the baseline SUV. The post-treatment SUV predicted for disease-free survival in the definitive chemoradiotherapy group. Caution should be exercised in using post-treatment PET scans to determine the necessity for surgical resection.

• OSTI ID: 21036234
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 69; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMBINED THERAPY
CORRELATIONS
DIAGNOSIS
FLUORODEOXYGLUCOSE
LYMPH NODES
MULTIVARIATE ANALYSIS
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
RADIOTHERAPY
SURGERY