Rizk Nabil P, Tang Laura, Adusumilli Prasad S, Bains Manjit S, Akhurst Timothy J, Ilson David, Goodman Karyn, Rusch Valerie W
Memorial Sloan-Kettering Cancer Center, New York City, New York 10021, USA.
J Thorac Oncol. 2009 Jul;4(7):875-9. doi: 10.1097/JTO.0b013e3181a8cebf.
We have previously shown that in early clinical stage esophageal adenocarcinoma, a positron emission tomography standardized uptake values (PET SUVmax) of <4.5 is associated with earlier pathologic stage and predicts better survival. In this study, we analyze the impact of the pretreatment PET SUVmax in patients with locally advanced esophageal adenocarcinoma who undergo preoperative chemoradiotherapy.
We performed a retrospective analysis, selecting patients with adenocarcinoma of the esophagus who had a pretreatment PET scan and who received chemoradiotherapy before esophagectomy. Data recorded included demographics, PET SUVmax, treatment details, pathologic details, and survival data. Comparison of categorical variables was done by chi analysis, continuous variables by t test, survival analysis by the Kaplan-Meier method, and comparisons of survival using the log-rank test.
Between January 1996 and September 2007, 189 patients were appropriate for this analysis. The initial PET SUVmax was <4.5 in 28 patients and >or=4.5 in 161 patients. The two groups were similar with regards to demographics and treatment details. Patients in the low SUV group were less likely to show evidence of treatment response after chemoradiotherapy, including a higher likelihood of residual nodal disease and a lower likelihood of a pathologic complete response and estimated treatment response. However, both groups had similar survival.
Although the initial PET SUVmax does not predict survival in patients with locally advanced esophageal adenocarcinoma who receive preoperative chemoradiotherapy, patients with a high initial SUVmax respond better to preoperative therapy. These results can be used to better select esophageal cancer patients for combined modality treatment.
我们之前已经表明，在临床早期阶段的食管腺癌中，正电子发射断层扫描标准化摄取值（PET SUVmax）<4.5与更早的病理分期相关，并预示着更好的生存率。在本研究中，我们分析了术前接受放化疗的局部晚期食管腺癌患者治疗前PET SUVmax的影响。
我们进行了一项回顾性分析，选择有治疗前PET扫描且在食管切除术前行放化疗的食管腺癌患者。记录的数据包括人口统计学资料、PET SUVmax、治疗细节、病理细节和生存数据。分类变量的比较采用卡方分析，连续变量采用t检验，生存分析采用Kaplan-Meier法，生存比较采用对数秩检验。
在1996年1月至2007年9月期间，189例患者适合本分析。初始PET SUVmax<4.5的患者有28例，≥4.5的患者有161例。两组在人口统计学资料和治疗细节方面相似。SUV值低的组在放化疗后显示治疗反应的证据较少，包括残留淋巴结疾病的可能性更高、病理完全缓解和估计治疗反应的可能性更低。然而，两组的生存率相似。
虽然初始PET SUVmax不能预测接受术前放化疗的局部晚期食管腺癌患者的生存情况，但初始SUVmax高的患者对术前治疗反应更好。这些结果可用于更好地选择食管癌患者进行综合治疗。
