Ineffectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography in the Evaluation of Tumor Response After Completion of Neoadjuvant Chemoradiation in Esophageal Cancer

作者：Guillaume Piessen, Grégory Petyt, Alain Duhamel, Xavier Mirabel, Damien G. Huglo, C. Mariette · 发表于：Annals of Surgery · 年份：2013 · DOI：10.1097/sla.0b013e31828676c4 · 被引用次数：82 · 研究领域：Esophageal Cancer Research and Treatment、Pancreatic and Hepatic Oncology Research、Head and Neck Cancer Studies

OBJECTIVE: To evaluate the role of ¹⁸F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in the assessment of tumor response after the completion of neoadjuvant chemoradiation (CRT) in patients with locally advanced resectable esophageal cancer. BACKGROUND: After primary CRT, a noninvasive evaluation of the tumor response could help in the treatment decision to identify patients who may benefit from surgery. Whether FDG-PET provides clinically relevant information remains questionable. METHODS: Operable patients with locally advanced esophageal cancer (clinically staged T3 N0-1 M0) were enrolled in this prospective study. The complete treatment plan included neoadjuvant CRT (cisplatin + 5-fluorouracil/45 Gy) followed 6 to 8 weeks later by a transthoracic en bloc esophagectomy. Morphological evaluation combined with FDG-PET was performed 2 weeks before the start of CRT and 4 to 6 weeks after the completion of CRT. Intratumoral pre- and posttreatment FDG-standardized uptake values (SUV1, SUV2, percentage change) were assessed. These variables were correlated with pathological and morphologic responses and survival. Investigators were blinded to the FDG-PET results unless they revealed metastatic disease. RESULTS: Of 60 total patients, 46 underwent the complete treatment plan (median age: 60.1 years; adenocarcinoma: 25 patients; squamous cell cancer: 21 patients). A major pathological response occurred in 45.7% of patients and was associated with a favorable outcome (P =...