title: Prediction of response to definitive chemoradiotherapy in esophageal cancer using positron emission tomography.
abstract: BACKGROUND
  Positron emission tomography (PET) with 18-F-fluorodeoxyglucose (FDG) has already proven useful in assessing the extension of esophageal carcinomas, detecting tumor recurrence and monitoring responses to therapy. The current study aims to assess the potential role of FDG-PET in predicting the response of esophageal squamous cell carcinoma (SCC) to definitive chemoradiotherapy (CRT).
  
  
  METHODS
  Twenty-seven patients with thoracic esophageal SCC who received definitive CRT between January 2001 and December 2005 underwent PET before and after CRT. The clinical evaluation of the primary tumor response to treatment was classified as either complete response (CR) or non-CR.
  
  
  RESULTS
  All patients had intensive FDG uptake in the primary tumor prior to CRT. The standardized uptake value (SUV) averaged 8.2+/-4.7 before CRT and decreased significantly to 2.8+/-1.8 after CRT (p<0.0001). The SUV before CRT averaged 10.2 in the non-CR group (n=17) and 4.9 in the CR group (n= 10). The SUV after CRT averaged 3.7 in the non-CR group and 1.4 in the CR group. The change in SUV for the CR group was higher than that in the non-CR group (p<0.05). The relationship between clinical features and clinical CR was analyzed using logistic regression analysis which revealed significant correlations between clinical CR and the longitudinal dimension of the tumor (p <0.05), SUV before CRT (p<0.05), SUV after CRT (p<0.01) and tumor classification (p <0.05). If the clinical features before CRT were limited, multivariate analysis revealed that the SUV before CRT was an independent predictor for clinical CR (p<0.05).
  
  
  CONCLUSIONS
  In predicting clinical evaluation of therapy prior to CRT, we suggest that SUV prior to definitive CRT is one of the most reliable predictors of response, along with tumor dimensions and classification.
authors: Departments of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi 371-8511, Japan. hiroyuki@po.wind.ne.jp
authors: Hiroyuki
authors: H
authors: Kato
authors: Minoru
authors: M
authors: Fukuchi
authors: Tatsuya
authors: T
authors: Miyazaki
authors: Masanobu
authors: M
authors: Nakajima
authors: Naritaka
authors: N
authors: Tanaka
authors: Takanori
authors: T
authors: Inose
authors: Hitoshi
authors: H
authors: Kimura
authors: Ahmad
authors: A
authors: Faried
authors: Kana
authors: K
authors: Saito
authors: Makoto
authors: M
authors: Sohda
authors: Yasuyuki
authors: Y
authors: Fukai
authors: Norihiro
authors: N
authors: Masuda
authors: Ryokuhei
authors: R
authors: Manda
authors: Hitoshi
authors: H
authors: Ojima
authors: Katsuhiko
authors: K
authors: Tsukada
authors: Noboru
authors: N
authors: Oriuchi
authors: Keigo
authors: K
authors: Endo
authors: Tetsuo
authors: T
authors: Nonaka
authors: Mariko
authors: M
authors: Shioya
authors: Hitoshi
authors: H
authors: Ishikawa
authors: Hideyuki
authors: H
authors: Sakurai
authors: Takashi
authors: T
authors: Nakano
authors: Hiroyuki
authors: H
authors: Kuwano
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18