Prognostic significance of PET assessment of metabolic response to therapy in oesophageal squamous cell carcinoma Journal Article
| Authors: | Chhabra, A.; Ong, L. T.; Kuk, D.; Ku, G.; Ilson, D.; Janjigian, Y. Y.; Wu, A.; Schoder, H.; Goodman, K. A. |
| Article Title: | Prognostic significance of PET assessment of metabolic response to therapy in oesophageal squamous cell carcinoma |
| Abstract: | The role of maximum standard uptake value (SUVmax) at baseline and after induction chemotherapy (CT) on positron emission tomography (PET) as an imaging biomarker has not been well established in oesophageal squamous cell carcinoma (SCC). In this retrospective analysis, we investigated the prognostic significance of various PET metrics in oesophageal SCC patients treated with induction chemotherapy followed by concurrent chemoradiotherapy (CRT).Methods:A total of 57 patients were treated with CRT; 52 patients received induction chemotherapy and 10 patients underwent surgery following CRT. Scans were independently analysed by a nuclear medicine physician blinded to patient outcome. Using region of interest analysis, SUVmax and metabolic tumour volume (MTV) were calculated for the index lesion and lymph node metastases in each patient. Kaplan-Meier analysis was used to evaluate overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS). Cox proportional hazards regression was used to assess correlation between outcomes and PET metrics.Results:Median follow-up for those who are alive was 4.4 years, with a median survival for all patients of 2.9 years. The 3-year OS, DFS, DMFS and LRFS rates were 47, 40, 44 and 36%, respectively. Using a pre-established cutoff of a 35% decrease in SUVmax from baseline to post-induction PET, 3-year OS for responders (≥35% decrease from baseline) was 64%, whereas non-responders (<35% decrease from baseline) had a 3-year OS of 15% (P=0.004).Conclusions:The pre-specified 35% decrease in SUVmax after induction chemotherapy was prognostic for OS. Baseline and post-induction PET metrics provide prognostic information for oesophageal SCC. © 2015 Cancer Research UK. |
| Keywords: | adult; aged; unclassified drug; major clinical study; overall survival; fluorouracil; cancer radiotherapy; disease free survival; positron emission tomography; follow up; lymph node metastasis; antineoplastic agent; antineoplastic metal complex; hemoglobin; retrospective study; irinotecan; cancer size; taxane derivative; fdg pet/ct; chemoradiotherapy; induction chemotherapy; esophageal squamous cell carcinoma; induction therapy; response assessment; esophagogastroduodenoscopy; local recurrence free survival; cancer prognosis; distant metastasis free survival; human; male; female; priority journal; article; oesophageal squamous cell carcinoma |
| Journal Title: | British Journal of Cancer |
| Volume: | 113 |
| Issue: | 12 |
| ISSN: | 0007-0920 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2015-12-22 |
| Start Page: | 1658 |
| End Page: | 1665 |
| Language: | English |
| DOI: | 10.1038/bjc.2015.416 |
| PROVIDER: | scopus |
| PMCID: | PMC4702001 |
| PUBMED: | 26657654 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 February 2016 -- Source: Scopus |
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