Digestive Oncology Unit, Hepatogastroenterology Department, Rouen University Hospital and University of Rouen, France.
Dig Liver Dis. 2012 Oct;44(10):875-9. doi: 10.1016/j.dld.2012.04.017. Epub 2012 Aug 9.
The purpose of the study was to investigate the value of 18F-fluorodeoxyglucose-positron emission tomography performed after definitive chemoradiotherapy in patients with locally advanced oesophageal carcinoma.
Forty consecutive patients underwent 18F-fluorodeoxyglucose-positron emission tomography at baseline and after chemoradiotherapy completion. Assessment of the clinical complete response to chemoradiotherapy included oesophagoscopy plus biopsies and computed tomography scan. Cox regression analysis was used to develop the univariate and multivariate models describing the association of the independent variables with survival and local control.
A clinical complete response and 18F-fluorodeoxyglucose-positron emission tomography response were present in 29 patients (72.5%) and 13 patients (32.5%), respectively. A combined response was observed in 11 patients (27.5%). During follow-up, a local failure was detected in 27.2% of patients with 18F-fluorodeoxyglucose-positron emission tomography response versus 33.3% in non-responders (p=.9). In multivariate analysis, clinical complete response (HR 5.77, p=.009) and 18F-fluorodeoxyglucose-positron emission tomography response (HR 6.27, p=.031) were identified as independent prognostic factors of overall survival.
In patients treated for an esophageal cancer, the present study suggested that 18F-fluorodeoxyglucose-positron emission tomography after chemoradiotherapy completion was an independent prognostic factor of overall survival without significant impact on local recurrence prediction.
本研究旨在探讨 18F-氟代脱氧葡萄糖正电子发射断层扫描(18F-FDG-PET)在局部晚期食管癌患者根治性放化疗后的价值。
连续 40 例患者在基线和放化疗完成后进行 18F-FDG-PET 检查。对放化疗后临床完全缓解的评估包括食管镜检查加活检和计算机断层扫描。采用 Cox 回归分析建立描述独立变量与生存和局部控制关系的单因素和多因素模型。
29 例(72.5%)患者和 13 例(32.5%)患者出现临床完全缓解和 18F-FDG-PET 缓解,联合缓解 11 例(27.5%)。在随访期间,有 18F-FDG-PET 反应的患者中有 27.2%出现局部失败,而无反应的患者中有 33.3%(p=.9)。多因素分析显示,临床完全缓解(HR 5.77,p=.009)和 18F-FDG-PET 缓解(HR 6.27,p=.031)是总生存的独立预后因素。
在接受食管癌治疗的患者中,本研究表明,放化疗后 18F-FDG-PET 是总生存的独立预后因素,对局部复发的预测无显著影响。