Visualisation of metastatic oesophageal and gastric cancer and prediction of clinical response to palliative chemotherapy using 18FDG PET.
OBJECTIVE
This study assessed the value of (18)F-deoxyglucose positron emission tomography (FDG-PET) for visualisation and early metabolic response assessment in metastatic gastro-oesophageal cancer.


METHODS
Twenty-six patients who were treated for metastatic disease (20 adenocarcinomas, 6 squamous cell cancers) underwent FDG-PET before and two weeks after the onset of palliative chemotherapy with either oxaliplatin + 5-FU/LV or with docetaxel + capecitabine. PET results were validated according to clinical response based on RECIST criteria.


RESULTS
Twenty-four tumours (92%) could be visualised by FDG-PET and were also assessable by a second PET scan at 2 weeks. The 2 tumours that were not detectable by PET were both gastric cancers belonging to the non-intestinal subtype according to Lauren. Median time to progression and overall survival were not significantly different for metabolic responders and non-responders (6.3 vs 5.3 months and 14.1 vs 12.5 months, respectively).


CONCLUSIONS
In this heterogeneous study population, FDG-PET had a limited accuracy in predicting clinical response. However, the metabolic response prediction was particularly good in the subgroup of patients with oesophageal squamous cell cancer. Therefore, FDG-PET and assessment of cancer therapy clearly merits further investigation in circumscribed patient populations with metastatic disease.
Lorenzen
S
S
3rd Department of Internal Medicine (Haematology/Medical Oncology), Klinikum rechts der Isar, Technical University, Ismaninger Strasse 22, Munich, Germany.
Herrmann
K
K
Weber
W A
WA
Wieder
H
H
Hennig
M
M
Ott
K
K
Bredenkamp
R
R
Peschel
C
C
Schwaiger
M
M
Lordick
F
F
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010166:Palliative Care / Q000379:methods*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D009944:Organoplatinum Compounds; D019275:Radiopharmaceuticals; D000077150:Oxaliplatin; D019788:Fluorodeoxyglucose F18; D002955:Leucovorin; D005472:Fluorouracil