Fluorodeoxyglucose Positron Emission Tomography for Evaluating Early Response During Neoadjuvant Chemoradiotherapy in Patients With Potentially Curable Esophageal Cancer

• DOI: 10.1097/sla.0b013e3181f66596
• Publication Date: 2011-01-13T08:39:37Z
• Authors: Mark van Heijl; Jikke M. Omloo; Mark I. van Berge...; Otto S. Hoekstra; Ronald Boellaard; Patrick M. Bossuyt; Olivier R. Busch; Hugo W. Tilanus; Maarten C. Hulshof; Ate van der Gaast; Grard A. Nieuwenh...; Han J. Bonenkamp; John Th. Plukker; Miguel A. Cuesta; Fiebo J. ten Kate; Jan Pruim; Herman van Dekken; Jacques J. Bergman; Gerrit W. Sloof; J. Jan van Lanschot
• Keywords: Chemoradiotherapy; Standardized uptake value; Fluorodeoxyglucose; Neoadjuvant Therapy; Esophagectomy

Neoadjuvant chemoradiotherapy before surgery can improve survival in patients with potentially curable esophageal cancer, but not all respond. Fluorodeoxyglucose positron emission tomography (FDG-PET) has been proposed to identify nonresponders early during neoadjuvant chemoradiotherapy. The aim of the present study was determine whether FDG-PET could differentiate between responding and nonresponding tumors course chemoradiotherapy.This clinical trial comprised serial 14 days after start carcinoma. Histopathologic responders were defined as no or less than 10% viable tumor cells (Mandard score on resection specimen). PET response measured using standardized uptake value (SUV). Receiver operating characteristic analysis used evaluate ability SUV distinguishing histopathologic nonresponders.In 100 included patients, 64 responders. median decrease therapy 30.9% for 1.7% (P = 0.001). In receiver analysis, area under curve 0.71 (95% CI 0.60-0.82). Using a 0% cutoff value, correctly identified 58 (sensitivity 91%) 18 36 (specificity 50%). corresponding positive negative predictive values 76% 75%, respectively.SUV significantly associated response, its accuracy detecting too low justify use discontinuation cancer.