title: Linear correlation between patient survival and decreased percentage of tumor [(18)F]fluorodeoxyglucose uptake for late-course accelerated hyperfractionated radiotherapy for esophageal cancer.
abstract: OBJECTIVE
  The aims of this trial were to study whether a decreased percentage of tumor fluorodeoxyglucose (FDG) uptake (%DeltaSUVmax) correlated with overall survival and local control times for patients with esophageal cancer and which patients would benefit from a late-course accelerated hyperfractionated (LCHF) radiation scheme.
  
  
  METHODS
  A total of 50 eligible patients with squamous esophageal cancer received positron-emission tomography examinations three times and were treated with the LCHF radiation scheme, with a dose of 68.4 Gy/41 fractions in 6.5 weeks. A %DeltaSUVmax value was calculated, and patients were stratified as highly radiosensitive (HR), moderately radiosensitive (MR), and low radiosensitivity (LR) according to %DeltaSUVmax values in the conventional fraction (CF) scheme. Then, a linear correlation was calculated between patients' survival time and %DeltaSUVmax. Local control and overall survival rates were compared after stratification.
  
  
  RESULTS
  In the MR subgroup, there was no linear correlation between %DeltaSUVmax and the CF and LCHF schemes (correlation coefficient, R < 0.4; p > 0.05). In the other subgroups (HR and LR), %DeltaSUVmax values between the CF and LCHF schemes were correlated. Also, in the HR and LR subgroups, %DeltaSUVmax after radiation correlated with overall survival or local control rates (correlation coefficient, R ＞0.5, and p < 0.05). Three-year local control rates in the HR, MR, and LR subgroups were 100%, 81.5%, and 0%, respectively (p < 0.001). Also, 3-year overall survival rates were 92.4%, 58.8%, and 0% for HR, MR, and LR subgroups, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Postradiation %DeltaSUVmax was positively correlated with survival time for patients' with esophageal cancer. Patients who benefited from LCHF schedules were those with a decrease of 30% to 60% in tumor FDG uptake after the completion of CF radiation.
authors.affiliation: Department of Oncology, Shandong University School of Medicine, Shandong Province, PR of China.
authors.forename: Jin-bo
authors.initials: JB
authors.lastname: Ma
authors.forename: Yi-peng
authors.initials: YP
authors.lastname: Song
authors.forename: Jin-ming
authors.initials: JM
authors.lastname: Yu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Er-cheng
authors.initials: EC
authors.lastname: Cheng
authors.forename: Xi-qin
authors.initials: XQ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D002681:China; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D000964:Antimetabolites, Antineoplastic; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil