Gillham C M, Lucey J A, Keogan M, Duffy G J, Malik V, Raouf A A, O'byrne K, Hollywood D, Muldoon C, Reynolds J V
Academic Unit of Clinical and Molecular Oncology, Trinity College Dublin, Trinity Centre, St James's Hospital, Dublin, Republic of Ireland.
Br J Cancer. 2006 Nov 6;95(9):1174-9. doi: 10.1038/sj.bjc.6603412. Epub 2006 Oct 3.
To determine whether [(18)F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) could predict the pathological response in oesophageal cancer after only the first week of neoadjuvant chemoradiation. Thirty-two patients with localised oesophageal cancer had a pretreatment PET scan and a repeat after the first week of chemoradiation. The change in mean maximum standardised uptake value (SUV) and volume of metabolically active tissue (MTV) was compared with the tumour regression grade (TRG) in the final histology. Those who achieved a TRG of 1 and 2 were deemed responders and 3-5 nonresponders. In the responders (28%), the SUV fell from 12.6 (+/-6.3) to 8.1 (+/-2.9) after 1 week of chemoradiation (P=0.070). In nonresponders (72%), the results were 9.7 (+/-5.4) and 7.1 (+/-3.8), respectively (P=0.003). The MTV in responders fell from 36.6 (+/-22.7) to 22.3 (+/-10.4) cm(3) (P=0.180), while in nonresponders, this fell from 35.9 (+/-36.7) to 31.9 (+/-52.7) cm(3) (P=0.405). There were no significant differences between responders and nonresponders. The hypothesis that early repeat FDG-PET scanning may predict histomorphologic response was not proven. This may reflect an inflammatory effect of radiation that obscures tumour-specific metabolic changes at this time. This assessment may have limited application in predicting response to multimodal regimens for oesophageal cancer.
为了确定[18F] - 氟脱氧葡萄糖 - 正电子发射断层扫描（FDG - PET）是否仅在新辅助放化疗第一周后就能预测食管癌的病理反应。32例局限性食管癌患者在新辅助放化疗前进行了PET扫描，并在放化疗第一周后进行了复查。将平均最大标准化摄取值（SUV）和代谢活跃组织体积（MTV）的变化与最终组织学检查中的肿瘤退缩分级（TRG）进行比较。TRG为1和2的患者被视为反应者，3 - 5级为无反应者。在反应者（28%）中，放化疗1周后SUV从12.6（±6.3）降至8.1（±2.9）（P = 0.070）。在无反应者（72%）中，结果分别为9.7（±5.4）和7.1（±3.8）（P = 0.003）。反应者的MTV从36.6（±22.7）降至22.3（±10.4）cm³（P = 0.180），而在无反应者中，MTV从35.9（±36.7）降至31.9（±52.7）cm³（P = 0.405）。反应者和无反应者之间无显著差异。早期重复FDG - PET扫描可预测组织形态学反应这一假设未得到证实。这可能反映了放疗的炎症效应，此时掩盖了肿瘤特异性代谢变化。这种评估在预测食管癌多模式治疗方案的反应方面应用可能有限。
