FDG-PET in the prediction of pathologic response after neoadjuvant chemoradiotherapy in locally advanced, resectable esophageal cancer

Yeol Song Si, Jong Hoon Kim, Sook Ryu Jin, Hyug Lee Gin, Bae Kim Sung, Il Park Seung, Ho Young Song, Kyung Ja Cho, Do Ahn Seung, Sang Wook Lee, Soo Shin Seong, Kyung Choi Eun

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107 Scopus citations

Abstract

Purpose: To assess the efficacy of 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting a pathologic response in locally advanced esophageal cancer after neoadjuvant chemoradiotherapy. Methods and Materials: All enrolled patients were treated with neoadjuvant chemoradiotherapy followed by esophagectomy and underwent two FDG-PET scans, before and after neoadjuvant chemoradiotherapy. We compared the results of the preoperative FDG-PET scans with the pathologic results. Results: From July 2001 to July 2004, 32 patients (29 men and 3 women) were enrolled in this study. Pathologic complete response (pCR) in the esophagus was achieved in 21 of 32 patients (66%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the primary tumors of the preoperative FDG-PET were 27%, 95%, 75%, and 71%, respectively. In regional lymph nodes, these values were 16%, 98%, 36%, and 93%, respectively. The mean standardized uptake value (SUV) of primary tumors was initially 5.6 ± 3.6 and changed to 1.5 ± 1.3 after neoadjuvant chemoradiotherapy (p < 0.05). If analysis of metabolic response (SUV decrease, ΔSUV) was limited to initially highly metabolic primary tumors (SUV <4.0), pathologic response was correlated with metabolic response (p = 0.006). Conclusions: This study suggested that the pathologic response of an initially highly metabolic tumor after neoadjuvant chemoradiotherapy could be correlated with the metabolic response, and FDG-PET can provide additional information on tumor response to chemoradiotherapy.

Original languageEnglish (US)
Pages (from-to)1053-1059
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume63
Issue number4
DOIs
StatePublished - Nov 15 2005
Externally publishedYes

Keywords

  • Esophageal cancer
  • FDG-PET
  • Pathologic response

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Si, Y. S., Kim, J. H., Jin, S. R., Gin, H. L., Sung, B. K., Seung, I. P., Song, H. Y., Cho, K. J., Seung, D. A., Lee, S. W., Seong, S. S., & Eun, K. C. (2005). FDG-PET in the prediction of pathologic response after neoadjuvant chemoradiotherapy in locally advanced, resectable esophageal cancer. International Journal of Radiation Oncology Biology Physics, 63(4), 1053-1059. https://doi.org/10.1016/j.ijrobp.2005.03.033