title: Prediction of outcome with FDG-PET in definitive chemoradiotherapy for esophageal cancer.
abstract: The purpose of this study was to assess the efficacy of ¹⁸F-fluoro-2-deoxy-glucose uptake positron emission tomography (FDG-PET) for the prediction of outcome in definitive chemoradiotherapy (CRT) for esophageal cancer. We enrolled 56 patients with esophageal cancer treated with definitive CRT and examined by FDG-PET before treatment. We examined the correlation of the maximum standardized uptake value (SUVmax) in FDG-PET of the primary tumor with overall survival (OS), progression-free survival (PFS), local control (LC) and response of the primary tumor. After definitive CRT, 30 patients had a clinical complete response (CR), making the CR rate 54%. For all 56 patients, the 2-year OS rate, PFS rate and LC rates were 64%, 38% and 51%, respectively. We divided the patients into two groups according to SUVmax: SUVmax < 10 (low-SUV) and ≥10 (high-SUV). The 2-year OS rates in the low- and high-SUV groups were 100% and 41%, the PFS rates were 73% and 19%, the LC rates were 71% and 39%, and the CR rates were 100% and 32%, respectively. A univariate analysis revealed significant differences between the low- and high-SUV group in OS, PFS, LC and response (P = 0.0005, 0.0002, 0.048, and <0.0001, respectively). SUVmax and T stage were significantly associated with OS, PFS, LC and response. A multivariate analysis showed significant differences between the SUVmax <10 and ≥10 groups in overall survival and response (P < 0.05). Our result suggests that the SUVmax in FDG-PET of the primary tumor before treatment may have prognostic value for esophageal cancer.
authors.affiliation: Department of Radiology, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita, 874-0838, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Atsumi
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Abe
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Shingo
authors.initials: S
authors.lastname: Baba
authors.forename: Takuro
authors.initials: T
authors.lastname: Isoda
authors.forename: Saiji
authors.initials: S
authors.lastname: Ohga
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Yoshitake
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinoto
authors.forename: Kaori
authors.initials: K
authors.lastname: Asai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000401:mortality*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; SUVmax; chemoradiotherapy; esophageal cancer