title: 18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients.
abstract: BACKGROUND
  The purpose of this study was to evaluate if a baseline, an interim or a post-chemoradiation (CTRT) 18-fluorodeoxy-glucose positron emission computed tomography (18F-FDG PET/CT) studies could provide information on pathologic response to CTRT and overall survival (OS).
  
  
  METHODS
  Thirty-one patients with histologically proven adenocarcinoma or squamous cell carcinoma of the oesophagus, fit for trimodality therapy were prospectively enrolled. Most were men (93.5%), and had a stage III cancer (74.2%). Chemotherapy consisted of oxaliplatin/5-fluorouracil (45.2%) and taxane/5-fluorouracil (54.8%). All patients underwent a baseline, an interim (performed 12 ± 2 days after the onset of CTRT) and a post-CTRT 18F-FDG PET/CT study. The 18F-FDG PET/CT variables evaluated were at baseline, interim and post-CTRT studies maximum standardised uptake value (SUV max) and total lesion glycolysis (TLG). Clinical and 18F-FDG PET/CT parameters were correlated with pathologic complete response (pathCR) and OS.
  
  
  RESULTS
  Among the 31 patients studied, 61.3% achieved a clinical complete response (cCR) and 87.1% had surgery. The median OS was 35.1 months (95% confidence interval (CI): 19.9-NA). PathCR rate was 22.2%. There was only a marginal association between cCR and pathCR (p = 0.06). None of the other variables was predictive of pathCR. There was association between OS and baseline TLG (p = 0.03) at the optimal cutoff TLG value of 75.15. Additionally, TLG and ΔTLG post-CTRT were also associated with OS (p = 0.01 and 0.03, respectively).
  
  
  CONCLUSIONS
  None of the PET parameters is predictive of pathCR but TLG at baseline and post-CTRT are prognostic of OS.
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Elena
authors: E
authors: Elimova
authors: Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Xuemei
authors: X
authors: Wang
authors: Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Elba
authors: E
authors: Etchebehere
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Hironori
authors: H
authors: Shiozaki
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Yusuke
authors: Y
authors: Shimodaira
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Roopma
authors: R
authors: Wadhwa
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Venkatram
authors: V
authors: Planjery
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Nikolaos
authors: N
authors: Charalampakis
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Mariela A
authors: MA
authors: Blum
authors: Department of Thoracic Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Wayne
authors: W
authors: Hofstetter
authors: Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Jeff H
authors: JH
authors: Lee
authors: Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Brian R
authors: BR
authors: Weston
authors: Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Manoop S
authors: MS
authors: Bhutani
authors: Department of Clinical Pharmacy, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Jane E
authors: JE
authors: Rogers
authors: Department of Pathology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Dipen
authors: D
authors: Maru
authors: Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Heath D
authors: HD
authors: Skinner
authors: Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
authors: Homer A
authors: HA
authors: Macapinlac
authors: Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA. Electronic address: jajani@mdanderson.org.
authors: Jaffer A
authors: JA
authors: Ajani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D059248:Chemoradiotherapy / Q000379:methods; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D000077150:Oxaliplatin; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012074:Remission Induction; D043823:Taxoids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D001952:Bridged-Ring Compounds; D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D019788:Fluorodeoxyglucose F18; C080625:taxane; D005472:Fluorouracil
keywords: 18F-FDG PET/CT; Chemoradiation; Early response evaluation; Gastroesophageal cancer; Pathologic response