18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients.
18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients.
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18-氟脱氧葡萄糖正电子发射计算机断层扫描可预测食道癌患者化学放疗后反应。
DOI：
10.1016/j.ejca.2015.07.044
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发表时间：
2015-11
期刊：
影响因子：
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通讯作者：
Ajani JA
中科院分区：
文献类型：
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作者：
Elimova E;Wang X;Etchebehere E;Shiozaki H;Shimodaira Y;Wadhwa R;Planjery V;Charalampakis N;Blum MA;Hofstetter W;Lee JH;Weston BR;Bhutani MS;Rogers JE;Maru D;Skinner HD;Macapinlac HA;Ajani JA
本研究的目的是评估基线、中期或放化疗后（CTRT）18F-FDGPET/CT研究是否可以提供CTRT的病理反应和总生存期（OS）的信息。前瞻性入组了31例经组织学证实的食管腺癌或鳞状细胞癌患者，适合三联疗法。大多数是男性（93.5%），患有III期癌症（74.2%）。化疗方案包括奥沙利铂/5-氟尿嘧啶（45.2%）和紫杉烷/5-氟尿嘧啶（54.8%）。所有患者均接受了基线、中期（CTRT开始后12+/-2天）和CTRT后18F-FDGPET/CT研究。评价的18F-FDGPET/CT变量为基线、中期和CTRT研究后的最大标准化摄取值（SUVmax）和总病变糖酵解（TLG）。临床和18F-FDGPET/CT参数与病理完全缓解（pathCR）和OS相关。在研究的31例患者中，61.3%达到临床完全缓解（cCR），87.1%接受手术。中位OS为35.1个月（95% CI：19.9 - NA）。PathCR率为22.2%。cCR和pathCR之间仅存在边缘相关性（p=0.06）。其他变量均不能预测pCR。在最佳截止TLG值75.15时，OS与基线TLG之间存在相关性（p=0.03）。此外，CTRT后TLG和ΔTLG也与OS相关（分别为p = 0.01和0.03）。PET参数均不能预测pCR，但基线和CTRT后的TLG可预测OS。
The purpose of this study was to evaluate if a baseline, an interim or a post-chemoradiation (CTRT) 18F-FDGPET/CT studies could provide information on pathologic response to CTRT and overall survival (OS). Thirty-one patients with histologically proven adenocarcinoma or squamous cell carcinoma of the esophagus, fit for trimodality therapy were prospectively enrolled. Most were men (93.5%), and had a stage III cancer (74.2%). Chemotherapy consisted of oxaliplatin/5-fluorouracil (45.2%) and taxane/5-fluorouracil (54.8%). All patients underwent a baseline, an interim (performed 12+/-2 days after onset of CTRT) and a post-CTRT 18F-FDGPET/CT study. The 18F-FDGPET/CT variables evaluated were at baseline, interim and post-CTRT studies maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG). Clinical and 18F-FDGPET/CT parameters were correlated with pathologic complete response (pathCR) and OS. Among the 31 patients studied, 61.3% achieved a clinical complete response (cCR) and 87.1% had surgery. The median OS was 35.1 months (95% CI: 19.9 – NA). PathCR rate was 22.2%. There was only a marginal association between cCR and pathCR (p=0.06). None of the other variables was predictive of pCR. There was association between OS and baseline TLG (p=0.03) at the optimal cutoff TLG value of 75.15. Additionally, TLG and ΔTLG post-CTRT were also associated with OS (p = 0.01 and 0.03, respectively). None of the PET parameters are predictive of pCR but TLG at baseline and post-CTRT are prognostic of OS.