Correlation of molecular response as measured by 18-FDG positron emission tomography with outcome after chemoradiotherapy in patients with esophageal carcinoma.

Authors

• Andre A Konski
• Jonathan D Cheng
• Melvyn Goldberg
• Tianyu Li
• Alan Maurer
• Jian Q Yu
• Oleh Haluszka
• Walter Scott
• Neal J Meropol
• Steven J Cohen
• Gary Freedman
• Louis M Weiner

Publication/Presentation Date

10-1-2007

Abstract

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.

Volume

69

Issue

2

First Page

358

Last Page

363

ISSN

0360-3016

Published In/Presented At

Konski, A. A., Cheng, J. D., Goldberg, M., Li, T., Maurer, A., Yu, J. Q., Haluszka, O., Scott, W., Meropol, N. J., Cohen, S. J., Freedman, G., & Weiner, L. M. (2007). Correlation of molecular response as measured by 18-FDG positron emission tomography with outcome after chemoradiotherapy in patients with esophageal carcinoma. International journal of radiation oncology, biology, physics, 69(2), 358–363. https://doi.org/10.1016/j.ijrobp.2007.03.053

Disciplines

Medicine and Health Sciences

PubMedID

17532577

Department(s)

Hematology-Medical Oncology Division

Document Type

Article