(18)F-fluorodeoxyglucose positron emission tomography immediately after chemoradiotherapy predicts prognosis in patients with locoregional postoperative recurrent esophageal cancer.
OBJECTIVE
The objectives of this study were to reveal the utility of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) within 7 days after chemoradiotherapy to predict prognosis in patients with postoperative recurrent esophageal cancer.


METHODS
Patients scheduled to undergo concurrent chemoradiotherapy for postoperative locoregional recurrence of esophageal cancer were recruited. Selection criteria were: (1) locoregional recurrence, (2) no previous radiation therapy, (3) planning treatment with concurrent chemoradiotherapy, (4) FDG-PET performed <2 weeks before chemoradiotherapy, and (5) no serious diabetes. FDG-PET was performed <7 days after chemoradiotherapy. No more treatment after chemoradiotherapy was given until disease progression was diagnosed according to the Response Evaluation Criteria in Solid Tumors (RECIST). Correlations of FDG-PET findings with cause-specific survival and local control rates were investigated prospectively.


RESULTS
Twenty patients were enrolled. Median observation period of patients who survived was 45.0 months. Median maximum standardized uptake value (SUV(max)) after chemoradiotherapy was 2.4, and median SUV(max) before chemoradiotherapy was 8.4. Cause-specific survival and local control rates were significantly better for patients with SUV(max) < or = 2.4 after chemoradiotherapy (log-rank test, P = 0.033 and 0.010, respectively). SUV(max) before chemoradiotherapy tended to be correlated only with cause-specific survival rate (log-rank test, P = 0.076). Change in metabolic activity of FDG was significantly correlated with local control rate (log-rank test, P = 0.042).


CONCLUSIONS
FDG-PET performed even <7 days after chemoradiotherapy predicts prognosis in patients with postoperative recurrent esophageal cancer.
Jingu
Keiichi
K
Department of Radiation Oncology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. kjingu-jr@rad.med.tohoku.ac.jp
Kaneta
Tomohiro
T
Nemoto
Kenji
K
Takeda
Ken
K
Ogawa
Yoshihiro
Y
Ariga
Hisanori
H
Koto
Masashi
M
Sakayauchi
Toru
T
Takai
Yoshihiro
Y
Takahashi
Shoki
S
Yamada
Shogo
S
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18