Department of Oncology, Oxford Cancer & Haematology Centre, Oxford, UK.
Eur Radiol. 2012 Sep;22(9):2035-43. doi: 10.1007/s00330-012-2459-5. Epub 2012 May 5.
Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response predicts pathological response to a standardised neoadjuvant chemotherapy regimen within a prospective clinical trial.
Consecutive patients staged with potentially curable oesophageal cancer who underwent treatment within a non-randomised clinical trial were included. A standardised chemotherapy regimen (two cycles of oxaliplatin and 5-fluorouracil) was used. PET/CT was performed before chemotherapy and repeated 24-28 days after the start of cycle 2.
Forty-eight subjects were included: mean age 65 years; 37 male. Using the median percentage reduction in SUV(max) (42%) to define metabolic response, pathological response was seen in 71% of metabolic responders (17/24) compared with 33% of non-responders (8/24; P = 0.009, sensitivity 68%, specificity 70%). Pathological response was seen in 81% of subjects with a complete metabolic response (13/16) compared with 38% of those with a less than complete response (12/32; P = 0.0042, sensitivity 52%, specificity 87%). There was no significant histology-based effect.
There was a significant association between metabolic response and pathological response; however, accuracy in predicting pathological response was relatively low.
有报道称，在新辅助化疗期间或之后，正电子发射断层扫描（PET）检查中肿瘤 18F-氟代脱氧葡萄糖（FDG）摄取的减少可能预测食管癌的病理反应。我们的目的是在一项前瞻性临床试验中确定代谢反应是否能预测对标准化新辅助化疗方案的病理反应。
连续纳入在非随机临床试验中接受治疗的、具有潜在可治愈性的食管癌分期患者。使用标准化的化疗方案（奥沙利铂和 5-氟尿嘧啶两个周期）。在化疗前和第 2 周期开始后 24-28 天进行 PET/CT 检查。
共纳入 48 例患者：平均年龄 65 岁；37 例男性。使用 SUV(max)的中位数降低百分比（42%）来定义代谢反应，代谢反应者（24 例中的 17 例）的病理反应率为 71%，而非反应者（24 例中的 8 例）为 33%（P=0.009，敏感性 68%，特异性 70%）。完全代谢反应者（16 例中的 13 例）的病理反应率为 81%，而不完全代谢反应者（32 例中的 12 例）为 38%（P=0.0042，敏感性 52%，特异性 87%）。无显著的基于组织学的影响。
代谢反应与病理反应之间存在显著关联；然而，预测病理反应的准确性相对较低。
