PURPOSE: To assess the efficacy of 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting a pathologic response in locally advanced esophageal cancer after neoadjuvant chemoradiotherapy. METHODS AND MATERIALS: All enrolled patients were treated with neoadjuvant chemoradiotherapy followed by esophagectomy and underwent two FDG-PET scans, before and after neoadjuvant chemoradiotherapy. We compared the results of the preoperative FDG-PET scans with the pathologic results. RESULTS: From July 2001 to July 2004, 32 patients (29 men and 3 women) were enrolled in this study. Pathologic complete response (pCR) in the esophagus was achieved in 21 of 32 patients (66%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the primary tumors of the preoperative FDG-PET were 27%, 95%, 75%, and 71%, respectively. In regional lymph nodes, these values were 16%, 98%, 36%, and 93%, respectively. The mean standardized uptake value (SUV) of primary tumors was initially 5.6 +/- 3.6 and changed to 1.5 +/- 1.3 after neoadjuvant chemoradiotherapy (p < 0.05). If analysis of metabolic response (SUV decrease, DeltaSUV) was limited to initially highly metabolic primary tumors (SUV > or =4.0), pathologic response was correlated with metabolic response (p = 0.006). CONCLUSIONS: This study suggested that the pathologic response of an initially highly metabolic tumor after neoadjuvant chemoradiotherapy could be correlated with the metabolic response, and FDG-PET can provide additional information on tumor response to chemoradiotherapy.
PURPOSE: To assess the efficacy of 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting a pathologic response in locally advanced esophageal cancer after neoadjuvant chemoradiotherapy. METHODS AND MATERIALS: All enrolled patients were treated with neoadjuvant chemoradiotherapy followed by esophagectomy and underwent two FDG-PET scans, before and after neoadjuvant chemoradiotherapy. We compared the results of the preoperative FDG-PET scans with the pathologic results. RESULTS: From July 2001 to July 2004, 32 patients (29 men and 3 women) were enrolled in this study. Pathologic complete response (pCR) in the esophagus was achieved in 21 of 32 patients (66%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the primary tumors of the preoperative FDG-PET were 27%, 95%, 75%, and 71%, respectively. In regional lymph nodes, these values were 16%, 98%, 36%, and 93%, respectively. The mean standardized uptake value (SUV) of primary tumors was initially 5.6 +/- 3.6 and changed to 1.5 +/- 1.3 after neoadjuvant chemoradiotherapy (p < 0.05). If analysis of metabolic response (SUV decrease, DeltaSUV) was limited to initially highly metabolic primary tumors (SUV > or =4.0), pathologic response was correlated with metabolic response (p = 0.006). CONCLUSIONS: This study suggested that the pathologic response of an initially highly metabolic tumor after neoadjuvant chemoradiotherapy could be correlated with the metabolic response, and FDG-PET can provide additional information on tumor response to chemoradiotherapy.
Authors: Andre Konski; Tianyu Li; Michael Christensen; Jonathan D Cheng; Jian Q Yu; Kevin Crawford; Oleh Haluszka; Jeffrey Tokar; Walter Scott; Neal J Meropol; Steven J Cohen; Alan Maurer; Gary M Freedman Journal: Radiother Oncol Date: 2012-06-07 Impact factor: 6.280
Authors: Joerg Theisen; Bernd Krause; Christian Peschel; Roland Schmid; Hans Geinitz; Helmut Friess Journal: World J Gastrointest Surg Date: 2009-11-30
Authors: Arta Monir Monjazeb; Greg Riedlinger; Mebea Aklilu; Kim R Geisinger; Girish Mishra; Scott Isom; Paige Clark; Edward A Levine; A William Blackstock Journal: J Clin Oncol Date: 2010-09-27 Impact factor: 44.544
Authors: Eugene Y Chang; Xin Li; Michael Jerosch-Herold; Ryan A Priest; C Kristian Enestvedt; Jingang Xu; Charles S Springer; Blair A Jobe Journal: J Gastrointest Surg Date: 2007-09-01 Impact factor: 3.452