Published October 2017 | Version v1
Journal article Metadata-only

Increased FDG uptake on late-treatment PET in non-tumour-affected oesophagus is prognostic for pathological complete response and disease recurrence in patients undergoing neoadjuvant radiochemotherapy

Creators

  • 1. University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology
  • 2. German Cancer Research Center (DKFZ), Heidelberg (Germany)
  • 3. German Cancer Consortium (DKTK), Dresden (Germany)
  • 4. University Hospital Carl Gustav Carus Technische Univ. Dresden (Germany). Dept. of Radiation Oncology
  • 5. Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany). PET Center, Inst. of Radiopharmaceutical Cancer Research
  • 6. National Center for Tumor Diseases (NCT), Dresden (Germany)
  • 7. University Hospital Carl Gustav Carus, Dresden (Germany). Dept. of Nuclear Medicine
  • 8. University Hospital Carl Gustav Carus Technische Univ. Dresden (DE). Dept. of Pathology
  • 9. National Center for Tumor Diseases (NCT), Dresden (DE)
  • 10. German Cancer Research Center (DKFZ), Heidelberg (DE)
  • 11. University Hospital Carl Gustav Carus Technische Univ. Dresden (DE). Dept. of Visceral, Thoracic and Vascular Surgery
  • 12. German Cancer Consortium (DKTK), Dresden (DE)

Description

Early side effects including oesophagitis are potential prognostic factors in patients undergoing radiochemotherapy (RCT) for locally advanced oesophageal cancer (LAEC). We assessed the prognostic value of 18F-fluorodeoxyglucose (FDG) uptake within irradiated non-tumour-affected oesophagus (NTO) during restaging positron emission tomography (PET) as a surrogate for inflammation/oesophagitis. This retrospective evaluation included 64 patients with LAEC who had completed neoadjuvant RCT and had successful oncological resection. All patients underwent FDG PET/CT before and after RCT. In the restaging PET scan maximum and mean standardized uptake values (SUVmax, SUVmean) were determined in the tumour and NTO. Univariate Cox regression with respect to overall survival, local control, distant metastases and treatment failure was performed. Independence of clinically relevant parameters was tested in a multivariate Cox regression analysis. Increased FDG uptake, measured in terms of SUVmean in NTO during restaging was significantly associated with complete pathological remission (p = 0.002) and did not show a high correlation with FDG response of the tumour (rho < 0.3). In the univariate analysis, increased SUVmax and SUVmean in NTO was associated with improved overall survival (p = 0.011, p = 0.004), better local control (p = 0.051, p = 0.044), a lower rate of treatment failure (p < 0.001 for both) and development of distant metastases (p = 0.012, p = 0.001). In the multivariate analysis, SUVmax and SUVmean in NTO remained a significant prognostic factor for treatment failure (p < 0.001, p = 0.004) and distant metastases (p = 0.040, p = 0.011). FDG uptake in irradiated normal tissues measured on restaging PET has significant prognostic value in patients undergoing neoadjuvant RCT for LAEC. This effect may potentially be of use in treatment personalization. (orig.)

Availability note (English)

Available from: http://dx.doi.org/10.1007/s00259-017-3742-0

Additional details

Identifiers

DOI
10.1007/s00259-017-3742-0;

Publishing Information

Journal Title
European Journal of Nuclear Medicine and Molecular Imaging
Journal Volume
44
Journal Issue
11
Journal Page Range
p. 1813-1822
ISSN
1619-7070
CODEN
EJNMA6

INIS

Country of Publication
Germany
Country of Input or Organization
Germany
INIS RN
48091695
Subject category
S62: RADIOLOGY AND NUCLEAR MEDICINE;
Descriptors DEI
CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; COMPUTERIZED TOMOGRAPHY; EFFICIENCY; ESOPHAGUS; FLUORINE 18; FLUORODEOXYGLUCOSE; INFLAMMATION; METASTASES; PATHOLOGICAL CHANGES; POSITRON COMPUTED TOMOGRAPHY; RADIOPHARMACEUTICALS; RADIOTHERAPY; REGRESSION ANALYSIS; SIDE EFFECTS; SURVIVAL CURVES; SURVIVAL TIME; UPTAKE
Descriptors DEC
ANTIMETABOLITES; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; BODY; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DRUGS; EMISSION COMPUTED TOMOGRAPHY; FLUORINE ISOTOPES; HOURS LIVING RADIOISOTOPES; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LABELLED COMPOUNDS; LIGHT NUCLEI; MATERIALS; MATHEMATICS; MEDICINE; NANOSECONDS LIVING RADIOISOTOPES; NEOPLASMS; NUCLEAR MEDICINE; NUCLEI; ODD-ODD NUCLEI; ORGANS; PATHOLOGICAL CHANGES; RADIOACTIVE MATERIALS; RADIOISOTOPES; RADIOLOGY; STATISTICS; SYMPTOMS; THERAPY; TOMOGRAPHY