Early metabolic response to chemoradiotherapy by interim FDG PET/CT is associated with better overall survival and histological response in esophageal cancers.
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
/ diagnostic imaging
Chemoradiotherapy
Esophageal Neoplasms
/ diagnostic imaging
Female
Fluorodeoxyglucose F18
France
/ epidemiology
Humans
Male
Middle Aged
Neoplasm Staging
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
Survival Analysis
Treatment Outcome
Young Adult
Cancer
Local recurrence
Oesophageal
PET
Prognosis
Radiotherapy
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
08
08
2018
revised:
09
12
2018
accepted:
10
12
2018
pubmed:
12
1
2019
medline:
30
1
2020
entrez:
12
1
2019
Statut:
ppublish
Résumé
Early assessment of response to neoadjuvant chemoradiotherapy (CRT) is crucial in determining the most suitable treatment strategy in locally advanced oesophageal cancer (LAEC). We evaluated the impact of early metabolic response during CRT on overall survival (OS) and histological response. Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment and during CRT after 20 Gy. 116 patients (Male: 66.4%, Median age: 63; squamous cell carcinomas (SCC): 70%) met inclusion criteria. Median OS was 21.7 months. There was a significant positive correlation between interim metabolic response and OS. In multivariate analysis, only metabolic response using the 50% cut-off value remained significantly associated with OS (IC95% = 0.28-0.73; p = 0.001). In this statistical analysis, surgery (p = 0.007) and T stage (p = 0.023) were also correlated with OS. There was a significant correlation between early metabolic response and local recurrence (Chi-squared test p = 0.0001). Early metabolic response using FDG PET/CT is associated with better OS, disease-free survival, local control and pathological response in patients treated by CRT for LAEC.
Sections du résumé
BACKGROUND
Early assessment of response to neoadjuvant chemoradiotherapy (CRT) is crucial in determining the most suitable treatment strategy in locally advanced oesophageal cancer (LAEC).
AIMS
We evaluated the impact of early metabolic response during CRT on overall survival (OS) and histological response.
METHODS
Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment and during CRT after 20 Gy.
RESULTS
116 patients (Male: 66.4%, Median age: 63; squamous cell carcinomas (SCC): 70%) met inclusion criteria. Median OS was 21.7 months. There was a significant positive correlation between interim metabolic response and OS. In multivariate analysis, only metabolic response using the 50% cut-off value remained significantly associated with OS (IC95% = 0.28-0.73; p = 0.001). In this statistical analysis, surgery (p = 0.007) and T stage (p = 0.023) were also correlated with OS. There was a significant correlation between early metabolic response and local recurrence (Chi-squared test p = 0.0001).
CONCLUSIONS
Early metabolic response using FDG PET/CT is associated with better OS, disease-free survival, local control and pathological response in patients treated by CRT for LAEC.
Identifiants
pubmed: 30630738
pii: S1590-8658(18)31301-X
doi: 10.1016/j.dld.2018.12.006
pii:
doi:
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
887-893Informations de copyright
Copyright © 2018. Published by Elsevier Ltd.