Sangwon Han1, Yong-Il Kim2, Sungmin Woo3, Tae-Hyung Kim4,5, Jin-Sook Ryu1. 1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. 2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. kyi821209@naver.com. 3. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. 5. Department of Radiology, Naval Pohang Hospital, Pohang, Korea.
Abstract
PURPOSE: To determine the prognostic and predictive value of early metabolic response assessed by a change in standardized uptake value (SUV) on interim 18F-FDG PET in patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy. METHODS: PubMed and Embase were searched up until 10 September, 2020, for studies evaluating a change in SUV on interim 18F-FDG PET for predicting a pathologic response, progression-free survival (PFS), or overall survival (OS) in patients with esophageal cancer. The sensitivity and specificity for predicting a pathologic response were pooled using bivariate and hierarchical summary receiver operating characteristic (HSROC) models. Meta-analytic pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) were derived using a random-effects model. RESULTS: A total of 11 studies (695 patients) were included in the meta-analysis. For nine studies assessing predictive accuracy, the pooled sensitivity and specificity of an early metabolic response for predicting a pathologic response were 0.80 (95% CI 0.61-0.91) and 0.54 (95% CI 0.45-0.63), respectively. The area under the HSROC curve was 0.64 (95% CI 0.60-0.68). Across the nine studies assessing prognostic value, an early metabolic response determined by interim PET showed pooled HRs for predicting PFS and OS of 0.44 (95% CI, 0.30-0.63) and 0.42 (95% CI, 0.31-0.56), respectively. CONCLUSION: Change in SUV on interim 18F-FDG PET had significant prognostic value and moderate predictive value for a pathologic response in esophageal cancer treated with neoadjuvant chemoradiotherapy. Interim 18F-FDG PET may help prognostic stratification and guide treatment planning in oncologic practice.
PURPOSE: To determine the prognostic and predictive value of early metabolic response assessed by a change in standardized uptake value (SUV) on interim 18F-FDG PET in patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy. METHODS: PubMed and Embase were searched up until 10 September, 2020, for studies evaluating a change in SUV on interim 18F-FDG PET for predicting a pathologic response, progression-free survival (PFS), or overall survival (OS) in patients with esophageal cancer. The sensitivity and specificity for predicting a pathologic response were pooled using bivariate and hierarchical summary receiver operating characteristic (HSROC) models. Meta-analytic pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) were derived using a random-effects model. RESULTS: A total of 11 studies (695 patients) were included in the meta-analysis. For nine studies assessing predictive accuracy, the pooled sensitivity and specificity of an early metabolic response for predicting a pathologic response were 0.80 (95% CI 0.61-0.91) and 0.54 (95% CI 0.45-0.63), respectively. The area under the HSROC curve was 0.64 (95% CI 0.60-0.68). Across the nine studies assessing prognostic value, an early metabolic response determined by interim PET showed pooled HRs for predicting PFS and OS of 0.44 (95% CI, 0.30-0.63) and 0.42 (95% CI, 0.31-0.56), respectively. CONCLUSION: Change in SUV on interim 18F-FDG PET had significant prognostic value and moderate predictive value for a pathologic response in esophageal cancer treated with neoadjuvant chemoradiotherapy. Interim 18F-FDG PET may help prognostic stratification and guide treatment planning in oncologic practice.
Authors: P van Hagen; M C C M Hulshof; J J B van Lanschot; E W Steyerberg; M I van Berge Henegouwen; B P L Wijnhoven; D J Richel; G A P Nieuwenhuijzen; G A P Hospers; J J Bonenkamp; M A Cuesta; R J B Blaisse; O R C Busch; F J W ten Kate; G-J Creemers; C J A Punt; J T M Plukker; H M W Verheul; E J Spillenaar Bilgen; H van Dekken; M J C van der Sangen; T Rozema; K Biermann; J C Beukema; A H M Piet; C M van Rij; J G Reinders; H W Tilanus; A van der Gaast Journal: N Engl J Med Date: 2012-05-31 Impact factor: 91.245
Authors: Megan Greally; Joanne F Chou; Daniela Molena; Valerie W Rusch; Manjit S Bains; Bernard J Park; Abraham J Wu; Karyn A Goodman; David P Kelsen; Yelena Y Janjigian; David H Ilson; Geoffrey Y Ku Journal: J Thorac Oncol Date: 2018-11-01 Impact factor: 15.609
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: N Hammoudi; C Hennequin; L Vercellino; A Costantini; A Valverde; P Cattan; L Quéro Journal: Dig Liver Dis Date: 2018-12-23 Impact factor: 4.088
Authors: Adam C Berger; Jeffrey Farma; Walter J Scott; Gary Freedman; Louis Weiner; Jonathan D Cheng; Hao Wang; Melvyn Goldberg Journal: J Clin Oncol Date: 2005-03-21 Impact factor: 44.544
Authors: Kazuto Harada; Xuemei Wang; Yusuke Shimodaira; Tara Sagebiel; Manoop S Bhutani; Jeffrey H Lee; Brian Weston; Elena Elimova; Quan Lin; Fatemeh G Amlashi; Dilsa Mizrak Kaya; Anthony Lopez; Mariela A Blum Murphy; Jack A Roth; Stephen G Swisher; Heath D Skinner; Wayne L Hofstetter; Jane E Rogers; Irene Thomas; Dipen M Maru; Ritsuko Komaki; Garrett Walsh; Jaffer A Ajani Journal: Target Oncol Date: 2018-02 Impact factor: 4.493