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Significance of mid-radiotherapy 18F-fluorodeoxyglucose positron emission tomography/computed tomography in esophageal cancer

Authors
 Byung Min Lee  ;  Chang Geol Lee 
Citation
 RADIOTHERAPY AND ONCOLOGY, Vol.171 : 114-120, 2022-06 
Journal Title
RADIOTHERAPY AND ONCOLOGY
ISSN
 0167-8140 
Issue Date
2022-06
MeSH
Esophageal Neoplasms* / diagnostic imaging ; Esophageal Neoplasms* / pathology ; Esophageal Neoplasms* / radiotherapy ; Fluorodeoxyglucose F18* / metabolism ; Humans ; Neoplasm Recurrence, Local ; Positron Emission Tomography Computed Tomography / methods ; Positron-Emission Tomography ; Prognosis ; Radiopharmaceuticals ; Retrospective Studies ; Tumor Burden
Keywords
Esophageal cancer ; Metabolism ; PET/CT ; Radiotherapy
Abstract
Background and purpose: Metabolic parameters evaluated by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) are known as prognostic markers in various cancers. We aimed to validate the predictive value of mid-radiotherapy (RT) FDG PET/CT parameters in esophageal cancer.

Materials and methods: Eighty-three patients treated with RT with or without chemotherapy between 2015 and 2020 were included. PET parameters including metabolic tumor volume (MTV), total lesion glycolysis, and mean (SUVmean) and maximum standardized uptake value (SUVmax) were analyzed. Locoregional recurrence-free rate (LRFR) and distant metastasis-free rate (DMFR) were analyzed.

Results: The median follow-up period was 10.5 months. Mid-RT SUVmax was significantly associated with LRFR (HR 1.07, p = 0.009) and DMFR (HR 1.13, p = 0.047) while mid-RT MTV was associated with DMFR (HR 1.06, p = 0.007). Treatment response after RT was associated with overall survival (HR, 1.52, p = 0.025). Further, treatment response was significantly associated with mid-RT SUVmax. The optimal cutoff value for mid-RT SUVmax in predicting LRFR and DMFR was 11 while cutoff value for mid-RT MTV was 15. The patients with mid-RT SUVmax ≤ 11 showed superior LRFR and DMFR compared to SUVmax > 11 (1-year LRFR; 73.4% vs. 48.4%, p = 0.028, 1-year DMFR; 74.6% vs. 40.7%, p = 0.007). The 1-year DMFR was significantly different between patients with mid-RT MTV ≤ 15 and >15 (1-year DMFR; 78.2% vs. 31.9%, p = 0.002).

Conclusion: Tumor metabolism changes during RT can be a useful predictive tool for treatment response and recurrence in patients with esophageal cancer. Clinicians may consider early response evaluation with PET during RT for predicting prognosis information about prognosis.
Full Text
https://www.sciencedirect.com/science/article/pii/S0167814022001918?via%3Dihub
DOI
10.1016/j.radonc.2022.04.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Lee, Byung Min(이병민)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188604
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