Tumor/normal esophagus ratio in 18F-fluorodeoxyglucose positron emission tomography/computed tomography for response and prognosis stratification after neoadjuvant chemotherapy for esophageal squamous cell carcinoma
Tumor/normal esophagus ratio in 18F-fluorodeoxyglucose positron emission tomography/computed tomography for response and prognosis stratification after neoadjuvant chemotherapy for esophageal squamous cell carcinoma
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DOI：
10.1007/s00535-015-1150-4
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发表时间：
2016-08-01
影响因子：
6.3
通讯作者：
Baba, Hideo
中科院分区：
文献类型：
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作者：
Izumi, Dasiuke;Yoshida, Naoya;Baba, Hideo
正电子发射断层扫描（PET）反应标准在实体瘤最近被提出作为一个标准化的方法，代谢和定量评估化疗的反应。然而，由于需要专用软件，这些标准的使用在许多机构受到限制。本研究收集了73例食管鳞状细胞癌患者的临床病理资料，分析F-18-氟脱氧葡萄糖PET/计算机断层扫描（PET/CT）肿瘤与正常食管（T/N）比值是否能预测新辅助化疗的疗效和预后。肝右叶和正常食管被用作诊断完全代谢反应（CMR）的参考组织。统计学方法采用Kaplan-Meier分析、单因素和多因素考克斯比例风险回归分析，根据最大标准摄取值（SUVmax）判断CMR者24例，根据T/N比值判断CMR者11例。虽然达到CMR的患者的预后比基于SUVmax的部分代谢应答的患者差，但是基于T/N比的SUVmax评估的应答与无病生存期（DFS）显著相关（P = 0.0011）。受试者工作特征曲线分析表明，用T/N比值评估SUVmax是预测pGrade 3的最佳指标。多因素分析显示，T/N比值评价SUVmax是预测病理缓解1级患者无病生存率的独立指标，可用于评价ESCC患者新辅助化疗的疗效。
Positron emission tomography (PET) response criteria in solid tumors were recently proposed as a standardized method for the metabolic and quantitative assessment of response to chemotherapy. However, use of these criteria is limited in many institutions because of the need for exclusive software. This study was designed to clarify whether tumor to normal esophageal (T/N) ratio on F-18-fluorodeoxyglucose PET/computed tomography could predict response to neoadjuvant chemotherapy and stratify prognosis in patients with esophageal squamous cell carcinoma (ESCC).Clinicopathological data were collected for 73 patients with ESCC who received neoadjuvant chemotherapy with docetaxel, cisplatin, and 5-fluorouracil followed by curative resection. The right liver lobe and normal esophagus were utilized as reference tissues for diagnosing complete metabolic response (CMR). Statistical methods included Kaplan-Meier analysis and univariate and multivariate Cox proportional hazards regression analyses.CMR was achieved in 24 patients on the basis of maximum standardized uptake value (SUVmax) and in 11 on the basis of SUVmax evaluation with T/N ratio. Although prognosis was poorer in patients who achieved CMR than partial metabolic response based on SUVmax, the responses were significantly correlated with disease-free survival (DFS) based on SUVmax evaluation with T/N ratio (P = 0.0011). Receiver operating characteristic curve analysis showed that SUVmax evaluation with T/N ratio was the best predictor of pGrade 3. Multivariate analysis showed that SUVmax evaluation with T/N ratio was an independent predictor of DFS in patients with pGrade 1 pathologic response.SUVmax evaluation with T/N ratio is useful for evaluating the effects of neoadjuvant chemotherapy in patients with ESCC.