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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-04-2013 | Original Article

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

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

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2013

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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Title: Evaluation of early response to concomitant chemoradiotherapy by interim 18F-FDG PET/CT imaging in patients with locally advanced oesophageal carcinomas
Authors: Xavier Cuenca
Christophe Hennequin
Elif Hindié
Sofia Rivera
Laetitia Vercellino
Valérie Baruch-Hennequin
Jean-Marc Gornet
Pierre Cattan
Mircea Chirica
Laurent Quéro
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2325-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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