PURPOSE: The purpose of this study was to evaluate the impact of FDG-PET following chemoradiotherapy (CRT) on treatment planning and survival in patients with oesophageal cancer (OC). METHODS: Fifty-three consecutive OC patients had a post-treatment PET scan to evaluate tumour response to CRT prior to possible surgery. Baseline pre-CRT PET was performed in 33 patients. Prospectively recorded post-CRT management plans were compared with post-PET treatment. High impact was defined as a change in treatment intent or modality. Survival was analysed using the Kaplan-Meier product limit method and Cox proportional hazards regression model. RESULTS: After completion of CRT, 23/53 patients (43%) achieved complete metabolic response (CMR), as compared with only four (8%) with complete response on computed tomography. High PET impact was observed in 19 patients (36%). CMR was strongly predictive of survival (p<0.008) on multivariate analysis. CMR patients in whom resection was not performed had comparable survival to those (CMR and non-CMR) who underwent resection. CONCLUSION: The use of post-treatment FDG-PET for assessment of tumour response after CRT changed the clinical management of more than one-third of OC patients. CMR status as assessed by PET powerfully stratified prognosis. Even in the absence of a baseline study, normalisation of uptake at all sites of known tumoral involvement carries a good medium-term prognosis.
PURPOSE: The purpose of this study was to evaluate the impact of FDG-PET following chemoradiotherapy (CRT) on treatment planning and survival in patients with oesophageal cancer (OC). METHODS: Fifty-three consecutive OC patients had a post-treatment PET scan to evaluate tumour response to CRT prior to possible surgery. Baseline pre-CRT PET was performed in 33 patients. Prospectively recorded post-CRT management plans were compared with post-PET treatment. High impact was defined as a change in treatment intent or modality. Survival was analysed using the Kaplan-Meier product limit method and Cox proportional hazards regression model. RESULTS: After completion of CRT, 23/53 patients (43%) achieved complete metabolic response (CMR), as compared with only four (8%) with complete response on computed tomography. High PET impact was observed in 19 patients (36%). CMR was strongly predictive of survival (p<0.008) on multivariate analysis. CMR patients in whom resection was not performed had comparable survival to those (CMR and non-CMR) who underwent resection. CONCLUSION: The use of post-treatment FDG-PET for assessment of tumour response after CRT changed the clinical management of more than one-third of OC patients. CMR status as assessed by PET powerfully stratified prognosis. Even in the absence of a baseline study, normalisation of uptake at all sites of known tumoral involvement carries a good medium-term prognosis.
Authors: Andrew Wirth; John F Seymour; Rodney J Hicks; Robert Ware; Richard Fisher; Miles Prince; Michael P MacManus; Gail Ryan; Henry Januszewicz; Max Wolf Journal: Am J Med Date: 2002-03 Impact factor: 4.965
Authors: W A Weber; K Ott; K Becker; H J Dittler; H Helmberger; N E Avril; G Meisetschläger; R Busch; J R Siewert; M Schwaiger; U Fink Journal: J Clin Oncol Date: 2001-06-15 Impact factor: 44.544
Authors: G Zuccaro; T W Rice; J Goldblum; S V Medendorp; M Becker; R Pimentel; L Gitlin; D J Adelstein Journal: Am J Gastroenterol Date: 1999-04 Impact factor: 10.864
Authors: R J Hicks; V Kalff; M P MacManus; R E Ware; A Hogg; A F McKenzie; J P Matthews; D L Ball Journal: J Nucl Med Date: 2001-11 Impact factor: 10.057
Authors: Matthias Schmidt; Elfriede Bollschweiler; Markus Dietlein; Stefan P Mönig; Carsten Kobe; Daniel Vallböhmer; Daniel Vallboehmer; Wolfgang Eschner; Arnulf Hölscher; Harald Schicha Journal: Eur J Nucl Med Mol Imaging Date: 2008-12-19 Impact factor: 9.236