title: The predictive value of 18F-FDG PET for pathological response of primary tumor in patients with esophageal cancer during or after neoadjuvant chemoradiotherapy: a meta-analysis.
abstract: OBJECTIVE
  We want to review the value of 18-fluoro-deoxy-glucose positron emission tomography for response prediction of primary tumor in patients with esophageal cancer during or after neoadjuvant chemoradiotherapy.
  
  
  METHODS
  Studies were searched in Pubmed, Embase and Cochrane Library with specific search strategy. The published articles were included according to the criteria established in advance. The included studies were divided into two groups according to the time of the repeat positron emission tomography: during (Group A) or after neoadjuvant chemoradiotherapy (Group B). The studies that performed the repeat positron emission tomography after neoadjuvant chemoradiotherapy were graded Quality Assessment of Diagnostic Accuracy Studies. The pooled sensitivity, specificity and diagnostic odds ratio were obtained for both groups on the basis of no-existing of threshold effect.
  
  
  RESULTS
  Fifteen studies were included in the present study. The threshold effect did not exist in both groups. The pooled sensitivity, specificity and diagnostic odds ratio were 85%, 59%, 6.82 with 95% confidence interval 76-91%, 48-69%, 2.25-20.72 in Group A. The equivalent values were 67%, 69%, 6.34 with 95% confidence interval 60-73%, 63-74%, 2.08-19.34 in Group B. The pooled sensitivity was 90% in four studies that enrolled patients with esophageal squamous cell carcinoma merely in Group B.
  
  
  CONCLUSIONS
  According to the present data, positron emission tomography should not be used routinely to guide treatment strategy in esophageal cancer patients. We speculated that positron emission tomography could be used as a tool to predict treatment response after neoadjuvant chemoradiotherapy in patients with esophageal squamous cell carcinoma.
authors.affiliation: Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, Shandong, China.
authors.forename: Lihong
authors.initials: L
authors.lastname: Cong
authors.affiliation: Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China.
authors.forename: Shikun
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, Shandong, China.
authors.forename: Teng
authors.initials: T
authors.lastname: Gao
authors.affiliation: Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, Shandong, China hulikuan_qilu@163.com.
authors.forename: Likuan
authors.initials: L
authors.lastname: Hu
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000628:therapy; D059248:Chemoradiotherapy; D016208:Databases, Factual; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D000077277:Esophageal Squamous Cell Carcinoma; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry*; D006801:Humans; D020360:Neoadjuvant Therapy; D016017:Odds Ratio; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000737:chemistry*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: esophageal neoplasms; meta-analysis; neoadjuvant chemoradiotherapy; positron emission tomography; response assessment