Positron emission tomography for assessment of the response to induction radiochemotherapy in locally advanced oesophageal cancer

被引:257
作者
Flamen, P
Van Cutsem, E
Lerut, A
Cambier, JP
Haustermans, K
Bormans, G
De Leyn, P
Van Raemdonck, D
De Wever, W
Ectors, N
Maes, A
Mortelmans, L
机构
[1] Catholic Univ Louvain, Hosp Gasthuisberg, Dept Nucl Med, B-3000 Louvain, Belgium
[2] Catholic Univ Louvain, Hosp Gasthuisberg, Dept Internal Med, B-3000 Louvain, Belgium
[3] Catholic Univ Louvain, Hosp Gasthuisberg, Dept Radiol, B-3000 Louvain, Belgium
[4] Catholic Univ Louvain, Hosp Gasthuisberg, Dept Pathol, B-3000 Louvain, Belgium
[5] Catholic Univ Louvain, Hosp Gasthuisberg, Dept Thorac Surg, B-3000 Louvain, Belgium
关键词
induction therapy; oesophageal cancer; positron emission tomography; response assessment; survival;
D O I
10.1093/annonc/mdf081
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aims: This prospective study was designed to determine the utility of F-18-labelled deoxyglucose (FDG) in positron emission tomography (PET) (FDG-PET) for assessing the response to neoadjuvant chemoradiation therapy (CRT) in locally advanced oesophageal tumours. Patients and methods: Thirty-six patients with locally advanced ocsophageal cancer (clinical T-4 stage) without organ metastases, underwent FDG-PET before and 1 month after CRT. Patients were classified as major responders by serial FDG-PET when the post-CRT PET demonstrated a strong reduction of FDG uptake at the primary tumour site (>80% reduction of tumour-to-liver uptake ratio) without any abnormal FDG uptake elsewhere in the body. PET response was compared with histology obtained during post-induction transthoracic oesophagectomy. Results: A strong correlation was found between the extent of lymph node (LN) involvement as shown by the pre-CRT PET and the major response rate (P = 0.001): such response occurred in nine of 11 N0M0 patients (82%), in three of nine N1-2M0 patients (33%) and in two of 16 patients (13%) with distant lymphatic spread. Such a correlation was not found for computed tomography or endoscopic ultrasonography. The sensitivity of serial FDG-PET for a major CRT response was 10 of 14 (71%), its specificity 18 of 22 (82%). The concordance between the response assessment by PET and histopathology was 78%. The median survival time after CRT of PET major responders compared with PET non-major responders was 16.3 months and 6.4 months, respectively. The metabolic response as measured by serial FDG-PET is a stronger prognostic factor for overall survival (P = 0.002) than the extent of LN involvement seen on the pretreatment FDG-PET (P = 0.087). Conclusions: These data indicate that CRT response as assessed by serial FDG-PET is strongly correlated with pathological response and survival.
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页码:361 / 368
页数:8
相关论文
共 17 条
[1]  
ADELSTEIN DJ, 1996, P AN M AM SOC CLIN, V15, P203
[2]   Concurrent radiation therapy and chemotherapy followed by esophagectomy for localized esophageal carcinoma [J].
Bates, BA ;
Detterbeck, FC ;
Bernard, SA ;
Qaqish, BF ;
Tepper, JE .
JOURNAL OF CLINICAL ONCOLOGY, 1996, 14 (01) :156-163
[3]   Chemoradiotherapy followed by surgery compared with surgery alone in squamous-cell cancer of the esophagus [J].
Bosset, JF ;
Gignoux, M ;
Triboulet, JP ;
Tiret, E ;
Mantion, G ;
Elias, D ;
Lozach, P ;
Ollier, JC ;
Pavy, JJ ;
Mercier, M ;
Sahmoud, T .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (03) :161-167
[4]  
Brücher BLDM, 2001, ANN SURG, V233, P300
[5]  
Chak A, 2000, CANCER, V88, P1788
[6]   Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma [J].
Flamen, P ;
Lerut, A ;
Van Cutsem, E ;
De Wever, W ;
Peeters, M ;
Stroobants, S ;
Dupont, P ;
Bormans, G ;
Hiele, M ;
De Leyn, P ;
Van Raemdonck, D ;
Coosemans, W ;
Ectors, N ;
Haustermans, K ;
Mortelmans, L .
JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (18) :3202-3210
[7]  
Flood WA, 1998, CANC TREAT, V98, P1
[8]  
KATLIC MR, 1990, J THORAC CARDIOV SUR, V99, P929
[9]  
KOLE AC, 1998, BRIT J CANCER, V9, P1863
[10]  
Luketich JD, 1999, ANN THORAC SURG, V68, P1133