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Evaluation of early response to concomitant chemoradiotherapy by interim 18F-FDG PET/CT imaging in patients with locally advanced oesophageal carcinomas

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The best way to assess the response to chemoradiotherapy of locally advanced oesophageal carcinomas is not known. We used 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to evaluate the metabolic response during chemoradiotherapy and tried to correlate this response to survival.

Methods

Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment (SUV1) and during chemoradiotherapy after two cycles of 5-fluorouracil (FU)/cisplatin and 20 Gy (SUV2). Metabolic response was defined as 1−(SUV2/SUV1). Surgery was discussed after 40 Gy and three cycles of chemotherapy. Results of interim PET were not considered for the therapeutic decision.

Results

Among 72 patients who underwent a first FDG PET/CT before any treatment, 59 (82 %) could receive the second FDG PET/CT examination. Median survival was 22.2 months with 1-year and 2-year survivals of 70 and 46 %, respectively. Nineteen patients (32 %) underwent surgery. Mean SUV1 and SUV2 were 12.3 ± 6.2 and 6 ± 4.1, respectively (p < 0.001). Using a cut-off for metabolic response of 50 %, sensitivity and specificity for survival were 0.7 and 0.58. The 2-year overall survival of good responders was 62 % as compared to 27 % for poor metabolic responders. A multivariate analysis was performed, including T and N stages, surgery, histology and metabolic response: only metabolic response was significantly (p = 0.009) associated with 2-year survival.

Conclusion

Early evaluation of metabolic response had a great prognostic value and could help identify good responders to chemoradiotherapy.

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Acknowledgements

Nadine Chaput and Marthe de Rosa for secretarial support.

Conflicts of interest

None.

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Author notes

  1. Elif Hindié

    Present address: Department of Nuclear Medicine, Haut-Lévêque Hospital, University of Bordeaux, CHU Bordeaux, France

Authors and Affiliations

  1. Department of Radiation Oncology, Saint Louis Hospital, AP-HP, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Xavier Cuenca, Christophe Hennequin, Sofia Rivera, Valérie Baruch-Hennequin & Laurent Quéro

  2. Nuclear Medicine Department, Saint Louis Hospital, AP-HP, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Elif Hindié & Laetitia Vercellino

  3. Denis Diderot University (Paris 7), Paris, France

    Xavier Cuenca, Christophe Hennequin, Elif Hindié, Sofia Rivera, Laetitia Vercellino, Valérie Baruch-Hennequin, Jean-Marc Gornet, Pierre Cattan, Mircea Chirica & Laurent Quéro

  4. Gastroenterology Department, Saint Louis Hospital, AP-HP, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Jean-Marc Gornet

  5. Surgery Department, Saint Louis Hospital, AP-HP, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Pierre Cattan & Mircea Chirica

  6. Department of Radiation Oncology, Saint Louis Hospital, AP-HP, 1 Avenue Claude Vellefeaux, 75010, Paris, France

    Laurent Quéro

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  1. Xavier Cuenca
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Correspondence to Laurent Quéro.

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Cuenca, X., Hennequin, C., Hindié, E. et al. Evaluation of early response to concomitant chemoradiotherapy by interim 18F-FDG PET/CT imaging in patients with locally advanced oesophageal carcinomas. Eur J Nucl Med Mol Imaging 40, 477–485 (2013). https://doi.org/10.1007/s00259-012-2325-3

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  • DOI: https://doi.org/10.1007/s00259-012-2325-3

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