Department of Radiation Oncology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Int J Clin Oncol. 2010 Apr;15(2):184-90. doi: 10.1007/s10147-010-0044-y. Epub 2010 Mar 10.
The objectives of this study were to reveal the utility of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) within 7 days after chemoradiotherapy to predict prognosis in patients with postoperative recurrent esophageal cancer.
Patients scheduled to undergo concurrent chemoradiotherapy for postoperative locoregional recurrence of esophageal cancer were recruited. Selection criteria were: (1) locoregional recurrence, (2) no previous radiation therapy, (3) planning treatment with concurrent chemoradiotherapy, (4) FDG-PET performed <2 weeks before chemoradiotherapy, and (5) no serious diabetes. FDG-PET was performed <7 days after chemoradiotherapy. No more treatment after chemoradiotherapy was given until disease progression was diagnosed according to the Response Evaluation Criteria in Solid Tumors (RECIST). Correlations of FDG-PET findings with cause-specific survival and local control rates were investigated prospectively.
Twenty patients were enrolled. Median observation period of patients who survived was 45.0 months. Median maximum standardized uptake value (SUV(max)) after chemoradiotherapy was 2.4, and median SUV(max) before chemoradiotherapy was 8.4. Cause-specific survival and local control rates were significantly better for patients with SUV(max) < or = 2.4 after chemoradiotherapy (log-rank test, P = 0.033 and 0.010, respectively). SUV(max) before chemoradiotherapy tended to be correlated only with cause-specific survival rate (log-rank test, P = 0.076). Change in metabolic activity of FDG was significantly correlated with local control rate (log-rank test, P = 0.042).
FDG-PET performed even <7 days after chemoradiotherapy predicts prognosis in patients with postoperative recurrent esophageal cancer.
本研究旨在揭示（18）氟-脱氧葡萄糖正电子发射断层扫描（FDG-PET）在放化疗后 7 天内的应用价值，以预测术后复发性食管癌患者的预后。
招募了计划接受同步放化疗治疗术后局部复发性食管癌的患者。入选标准为：（1）局部复发，（2）无既往放疗史，（3）计划采用同步放化疗治疗，（4）FDG-PET 检查在放化疗前<2 周进行，（5）无严重糖尿病。FDG-PET 检查在放化疗后<7 天进行。放化疗后不再进行其他治疗，直至根据实体瘤反应评估标准（RECIST）诊断疾病进展。前瞻性研究 FDG-PET 结果与特异性生存和局部控制率的相关性。
共纳入 20 例患者。存活患者的中位观察期为 45.0 个月。放化疗后最大标准化摄取值（SUV(max)）中位数为 2.4，放化疗前 SUV(max)中位数为 8.4。放化疗后 SUV(max)≤2.4 的患者特异性生存率和局部控制率显著更好（对数秩检验，P=0.033 和 0.010）。放化疗前 SUV(max)仅与特异性生存率相关（对数秩检验，P=0.076）。FDG 代谢活性的变化与局部控制率显著相关（对数秩检验，P=0.042）。
即使在放化疗后<7 天进行 FDG-PET 检查，也可以预测术后复发性食管癌患者的预后。
