Song Si Yeol, Kim Jong Hoon, Ryu Jin Sook, Lee Gin Hyug, Kim Sung Bae, Park Seung Il, Song Ho-Young, Cho Kyung-Ja, Ahn Seung Do, Lee Sang-Wook, Shin Seong Soo, Choi Eun Kyung
Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.
Int J Radiat Oncol Biol Phys. 2005 Nov 15;63(4):1053-9. doi: 10.1016/j.ijrobp.2005.03.033. Epub 2005 Jun 20.
To assess the efficacy of 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting a pathologic response in locally advanced esophageal cancer after neoadjuvant chemoradiotherapy.
All enrolled patients were treated with neoadjuvant chemoradiotherapy followed by esophagectomy and underwent two FDG-PET scans, before and after neoadjuvant chemoradiotherapy. We compared the results of the preoperative FDG-PET scans with the pathologic results.
From July 2001 to July 2004, 32 patients (29 men and 3 women) were enrolled in this study. Pathologic complete response (pCR) in the esophagus was achieved in 21 of 32 patients (66%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the primary tumors of the preoperative FDG-PET were 27%, 95%, 75%, and 71%, respectively. In regional lymph nodes, these values were 16%, 98%, 36%, and 93%, respectively. The mean standardized uptake value (SUV) of primary tumors was initially 5.6 +/- 3.6 and changed to 1.5 +/- 1.3 after neoadjuvant chemoradiotherapy (p < 0.05). If analysis of metabolic response (SUV decrease, DeltaSUV) was limited to initially highly metabolic primary tumors (SUV > or =4.0), pathologic response was correlated with metabolic response (p = 0.006).
This study suggested that the pathologic response of an initially highly metabolic tumor after neoadjuvant chemoradiotherapy could be correlated with the metabolic response, and FDG-PET can provide additional information on tumor response to chemoradiotherapy.
评估18氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在预测局部晚期食管癌新辅助放化疗后病理反应方面的疗效。
所有入组患者均接受新辅助放化疗，随后进行食管切除术，并在新辅助放化疗前后各进行一次FDG-PET扫描。我们将术前FDG-PET扫描结果与病理结果进行了比较。
2001年7月至2004年7月，本研究共纳入32例患者（29例男性和3例女性）。32例患者中有21例（66%）实现了食管病理完全缓解（pCR）。术前FDG-PET在原发肿瘤中的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为27%、95%、75%和71%。在区域淋巴结中，这些值分别为16%、98%、36%和93%。原发肿瘤的平均标准化摄取值（SUV）最初为5.6±3.6，新辅助放化疗后变为1.5±1.3（p<0.05）。如果将代谢反应分析（SUV降低，ΔSUV）仅限于最初高代谢的原发肿瘤（SUV≥4.0），则病理反应与代谢反应相关（p = 0.006）。
本研究表明，新辅助放化疗后最初高代谢肿瘤的病理反应可能与代谢反应相关，并且FDG-PET可以提供有关肿瘤对放化疗反应的额外信息。
