PURPOSE: Early detection of a response to neoadjuvant chemotherapy for locally advanced rectal cancer may spare patients from additional toxic but ineffective chemotherapy. Using (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET), we evaluated tumor response prospectively in the early course of preoperative chemotherapy. METHODS: The subjects were 15 patients who received neoadjuvant chemotherapy (XELOX or XELOX plus bevacizumab) for locally advanced rectal cancer. Patients underwent (18)F-FDG PET before chemotherapy, at the end of the first cycle of chemotherapy, and before surgical resection. Magnetic resonance imaging (MRI) was performed before chemotherapy, after the second cycle of chemotherapy, and before resection. After resection, the SUVmax and diameter were compared and graded according to the tumor regression grade (TRG). RESULTS: The TRG was assessed as TRG1 in one patient, TRG2 in five patients, and TRG3 in nine patients. We divided the patients into two groups: non-responders (NR) included the TRG1 and TRG2 patients, and responders (R) included the TRG3 patients. The tumor size before surgery was significantly smaller in the R group than in the NR group. The SUVmax at the end of the first cycle of chemotherapy and before surgical resection was significantly lower in the R group than in the NR group. CONCLUSION: Performing (18)F-FDG PET at the end of the first cycle of chemotherapy allowed us to predict the pathological response of locally advanced rectal cancer.
PURPOSE: Early detection of a response to neoadjuvant chemotherapy for locally advanced rectal cancer may spare patients from additional toxic but ineffective chemotherapy. Using (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET), we evaluated tumor response prospectively in the early course of preoperative chemotherapy. METHODS: The subjects were 15 patients who received neoadjuvant chemotherapy (XELOX or XELOX plus bevacizumab) for locally advanced rectal cancer. Patients underwent (18)F-FDG PET before chemotherapy, at the end of the first cycle of chemotherapy, and before surgical resection. Magnetic resonance imaging (MRI) was performed before chemotherapy, after the second cycle of chemotherapy, and before resection. After resection, the SUVmax and diameter were compared and graded according to the tumor regression grade (TRG). RESULTS: The TRG was assessed as TRG1 in one patient, TRG2 in five patients, and TRG3 in nine patients. We divided the patients into two groups: non-responders (NR) included the TRG1 and TRG2patients, and responders (R) included the TRG3patients. The tumor size before surgery was significantly smaller in the R group than in the NR group. The SUVmax at the end of the first cycle of chemotherapy and before surgical resection was significantly lower in the R group than in the NR group. CONCLUSION: Performing (18)F-FDG PET at the end of the first cycle of chemotherapy allowed us to predict the pathological response of locally advanced rectal cancer.
Entities:
Keywords:
FDG-PET; Neoadjuvant chemotherapy; Rectal cancer
Authors: Deborah Schrag; Martin R Weiser; Karyn A Goodman; Mithat Gonen; Ellen Hollywood; Andrea Cercek; Diane L Reidy-Lagunes; Marc J Gollub; Jinru Shia; Jose G Guillem; Larissa K F Temple; Philip B Paty; Leonard B Saltz Journal: J Clin Oncol Date: 2014-01-13 Impact factor: 44.544
Authors: Corrie A M Marijnen; Cornelis J H van de Velde; Hein Putter; Mandy van den Brink; Cornelis P Maas; Hendrik Martijn; Harm J Rutten; Theo Wiggers; Elma Klein Kranenbarg; Jan-Willem H Leer; Anne M Stiggelbout Journal: J Clin Oncol Date: 2005-03-20 Impact factor: 44.544
Authors: M J E M Gosens; R C Dresen; H J T Rutten; G A P Nieuwenhuijzen; J A W M van der Laak; H Martijn; I Tan-Go; I D Nagtegaal; A J C van den Brule; J H J M van Krieken Journal: Ann Oncol Date: 2008-07-29 Impact factor: 32.976
Authors: Jose G Guillem; Harvey G Moore; Timothy Akhurst; David S Klimstra; Leyo Ruo; Madhu Mazumdar; Bruce D Minsky; Leonard Saltz; W Douglas Wong; Steven Larson Journal: J Am Coll Surg Date: 2004-07 Impact factor: 6.113
Authors: Lisa A Min; Francesca Castagnoli; Wouter V Vogel; Jisk P Vellenga; Joost J M van Griethuysen; Max J Lahaye; Monique Maas; Regina G H Beets Tan; Doenja M J Lambregts Journal: Br J Radiol Date: 2021-08-13 Impact factor: 3.629