Prediction of disease-free survival using relative change in FDG-uptake early during neoadjuvant chemoradiotherapy for potentially curable esophageal cancer: A prospective cohort study

SUMMARY 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) has been investigated as a tool for monitoring response to neoadjuvant chemo- and chemoradiotherapy (CT and CRT, respectively) and as a predictor for survival in patients with esophageal cancer. In contrast to patients who undergo...

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Published in:	Diseases of the esophagus Vol. 30; no. 2; pp. 1 - 7
Main Authors:	Hagen, P. v., Heijl, M. v., Henegouwen, M. I. v. B., Boellaard, R., Bossuyt, P. M. M., Kate, F. J. W. t., Dekken, H. v., Hoekstra, O. S., Sloof, G. W., Lanschot, J. J. B. v.
Format:	Journal Article
Language:	English
Published:	United States Oxford University Press 01-02-2017
Subjects:	Adult Aged Chemoradiotherapy, Adjuvant - methods Disease Progression Disease-Free Survival Esophageal Neoplasms - diagnostic imaging Esophageal Neoplasms - pathology Esophageal Neoplasms - therapy Female Fluorodeoxyglucose F18 Follow-Up Studies Humans Male Middle Aged Multivariate Analysis Neoadjuvant Therapy - methods Positron-Emission Tomography - methods Predictive Value of Tests Prospective Studies Radiopharmaceuticals Treatment Outcome esophageal cancers chemoradiotherapy 18F-fluorodeoxyglucose positron emission tomography
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Summary:	SUMMARY 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) has been investigated as a tool for monitoring response to neoadjuvant chemo- and chemoradiotherapy (CT and CRT, respectively) and as a predictor for survival in patients with esophageal cancer. In contrast to patients who undergo neoadjuvant CT, it is not known whether patients who are clinically identified as responders after neoadjuvant CRT show better disease-free survival (DFS) than patients identified as nonresponders. The aim of the study was to determine the predictive value of FDG-uptake measured prior to and early during neoadjuvant CRT. Patients treated with neoadjuvant CRT between 2004 and 2009 within a randomized trial were included. FDG-uptake was measured at baseline and after 14 days of CRT. According to the PERCIST-criteria, patients were allocated to have metabolic response, stable disease, or progression. Patients were followed until recurrence of disease or death. The predictive value of FDG-PET was determined with univariable and multivariable analysis in patients who underwent potentially curative surgery. One-hundred and six patients were included in the analysis. Minimal follow-up for surviving patients was 60 months. No significant differences in DFS were found between patients with metabolic response, stable disease, or progression, with 5-year DFS rates of 66%, 53%, and 67%, respectively (P = 0.39). Relative change in FDG uptake after 14 days of CRT is not associated with DFS in patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy followed by surgery. These measurements should not be used for prognostication in this specific group of patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1120-8694 1442-2050
DOI:	10.1111/dote.12479