Whole body 18FDG-PET and the response of esophageal cancer to induction therapy: Results of a prospective trial Journal Article


Authors: Downey, R. J.; Akhurst, T.; Ilson, D.; Ginsberg, R.; Bains, M. S.; Gonen, M.; Koong, H.; Gollub, M.; Minsky, B. D.; Zakowski, M.; Turnbull, A.; Larson, S. M.; Rusch, V.
Article Title: Whole body 18FDG-PET and the response of esophageal cancer to induction therapy: Results of a prospective trial
Abstract: Purpose: Whole-body 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) imaging before and after induction therapy was prospectively evaluated in patients with esophageal cancer to determine whether changes in PET images could measure response to therapy. Patients and Methods: Between April 1997 and April 1999, 39 patients (34 men and five women; median age, 59 years; range, 36 to 76 years) with esophageal cancer were prospectively enrolled in a single-institution clinical trial of staging, including PET, induction therapy, restaging including PET, and esophagectomy. All patients undergoing esophagectomy after induction therapy (n = 17) were followed either to recurrence, to death, or through a disease-free interval of at least 24 months. Results: PET after standard staging studies and before therapy imaged undetected sites of metastatic disease in six patients (15%). Restaging (including PET) after induction therapy did not identify any patients with disease progression or any patients with loco-regionally unresectable disease at exploration. The median decrease in the standardized uptake value (SUV) during induction therapy was 59%. After Ro esophagectomy, the 2-year disease-free and overall survival was 38% and 63%, respectively, among patients who had a less than 60% decrease in SUV, and 67% and 89%, respectively, among patients who had a greater than 60% decrease in SUV (P = .055 and P = .088, respectively). Conclusion: Compared with conventional imaging, PET detects additional sites of metastatic disease at initial evaluation. After induction therapy, PET did not add to the estimation of loco-regional resectability and did not detect new distant metastases. However, changes in [18F]FDG PET may predict disease-free and overall survival after induction therapy and resection in patients with esophageal cancer. Further evaluation in larger trials is warranted. © 2003 by American Society of Clinical Oncology.
Keywords: adult; clinical article; controlled study; human tissue; treatment outcome; treatment response; aged; disease-free survival; middle aged; overall survival; clinical trial; disease course; histopathology; cancer recurrence; cancer growth; comparative study; disease free survival; cancer staging; positron emission tomography; follow up; antineoplastic agent; prospective study; prospective studies; radiopharmaceuticals; metastasis; controlled clinical trial; antineoplastic combined chemotherapy protocols; cancer therapy; cancer mortality; diagnostic agent; quantitative analysis; disease progression; fluorodeoxyglucose f 18; computer assisted emission tomography; fluorodeoxyglucose f18; neoplasm metastasis; prediction and forecasting; predictive value of tests; radiopharmaceutical agent; scintiscanning; esophagus resection; esophagus cancer; esophagus tumor; esophageal neoplasms; esophagectomy; tomography, emission-computed; humans; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 21
Issue: 3
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2003-02-01
Start Page: 428
End Page: 432
Language: English
DOI: 10.1200/jco.2003.04.013
PUBMED: 12560430
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Valerie W Rusch
    657 Rusch
  2. Bruce Minsky
    264 Minsky
  3. Marc J Gollub
    111 Gollub
  4. Robert J Ginsberg
    138 Ginsberg
  5. Mithat Gonen
    716 Gonen
  6. Maureen F Zakowski
    280 Zakowski
  7. Timothy J Akhurst
    134 Akhurst
  8. David H Ilson
    275 Ilson
  9. Robert J Downey
    203 Downey
  10. Steven M Larson
    778 Larson
  11. Manjit S Bains
    229 Bains