Christina T Muijs1, Jannet C Beukema2, Dankert Woutersen3, Veronique E Mul2, Maaike J Berveling2, Jan Pruim4, Eric J van der Jagt5, Geke A P Hospers6, Henk Groen7, John Th Plukker8, Johannes A Langendijk2. 1. Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: c.t.muijs@umcg.nl. 2. Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 3. Department of Radiation Oncology, Medical Spectrum Twente, Enschede, The Netherlands. 4. Department of Molecular Imaging and Nuclear Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Nuclear Medicine, Stellenbosch University, South Africa. 5. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 6. Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 7. Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 8. Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: The aim of this prospective study was to determine the proportion of locoregional recurrences (LRRs) that could have been prevented if radiotherapy treatment planning for oesophageal cancer was based on PET/CT instead of CT. MATERIALS AND METHODS: Ninety oesophageal cancer patients, eligible for high dose (neo-adjuvant) (chemo)radiotherapy, were included. All patients underwent a planning FDG-PET/CT-scan. Radiotherapy target volumes (TVs) were delineated on CT and patients were treated according to the CT-based treatment plans. The PET images remained blinded. After treatment, TVs were adjusted based on PET/CT, when appropriate. Follow up included CT-thorax/abdomen every 6months. If LRR was suspected, a PET/CT was conducted and the site of recurrence was compared to the original TVs. If the LRR was located outside the CT-based clinical TV (CTV) and inside the PET/CT-based CTV, we considered this LRR possibly preventable. RESULTS: Based on PET/CT, the gross tumour volume (GTV) was larger in 23% and smaller in 27% of the cases. In 32 patients (36%), >5% of the PET/CT-based GTV would be missed if the treatment planning was based on CT. The median follow up was 29months. LRRs were seen in 10 patients (11%). There were 3 in-field recurrences, 4 regional recurrences outside both CT-based and PET/CT-based CTV and 3 recurrences at the anastomosis without changes in TV by PET/CT; none of these recurrences were considered preventable by PET/CT. CONCLUSION: No LRR was found after CT-based radiotherapy that could have been prevented by PET/CT. The value of PET/CT for radiotherapy seems limited.
BACKGROUND: The aim of this prospective study was to determine the proportion of locoregional recurrences (LRRs) that could have been prevented if radiotherapy treatment planning for oesophageal cancer was based on PET/CT instead of CT. MATERIALS AND METHODS: Ninety oesophageal cancerpatients, eligible for high dose (neo-adjuvant) (chemo)radiotherapy, were included. All patients underwent a planning FDG-PET/CT-scan. Radiotherapy target volumes (TVs) were delineated on CT and patients were treated according to the CT-based treatment plans. The PET images remained blinded. After treatment, TVs were adjusted based on PET/CT, when appropriate. Follow up included CT-thorax/abdomen every 6months. If LRR was suspected, a PET/CT was conducted and the site of recurrence was compared to the original TVs. If the LRR was located outside the CT-based clinical TV (CTV) and inside the PET/CT-based CTV, we considered this LRR possibly preventable. RESULTS: Based on PET/CT, the gross tumour volume (GTV) was larger in 23% and smaller in 27% of the cases. In 32 patients (36%), >5% of the PET/CT-based GTV would be missed if the treatment planning was based on CT. The median follow up was 29months. LRRs were seen in 10 patients (11%). There were 3 in-field recurrences, 4 regional recurrences outside both CT-based and PET/CT-based CTV and 3 recurrences at the anastomosis without changes in TV by PET/CT; none of these recurrences were considered preventable by PET/CT. CONCLUSION: No LRR was found after CT-based radiotherapy that could have been prevented by PET/CT. The value of PET/CT for radiotherapy seems limited.
Authors: Kinga Dębiec; Jerzy Wydmański; Izabela Gorczewska; Paulina Leszczyńska; Kamil Gorczewski; Wojciech Leszczyński; Andrea d’Amico; Michał Kalemba Journal: Asian Pac J Cancer Prev Date: 2017-11-26
Authors: Sweet Ping Ng; Jennifer Tan; Glen Osbourne; Luke Williams; Mathias A B Bressel; Rodney J Hicks; Eddie W F Lau; Julie Chu; Samuel Y K Ngan; Trevor Leong Journal: Clin Transl Radiat Oncol Date: 2017-03-07
Authors: Sophie E Vollenbrock; Marlies E Nowee; Francine E M Voncken; Alexis N T J Kotte; Lucas Goense; Peter S N van Rossum; Astrid L H M W van Lier; Stijn W Heijmink; Annemarieke Bartels-Rutten; Frank J Wessels; Berthe M P Aleman; Luc Dewit; Linda G W Kerkmeijer; Edwin P M Jansen; Martijn Intven; Irene M Lips; Gert J Meijer; Jasper Nijkamp Journal: Adv Radiat Oncol Date: 2019-04-24