Metser Ur, Rashidi Farid, Moshonov Hadas, Wong Rebecca, Knox Jennifer, Guindi Maha, Darling Gail
Joint Department of Medical Imaging, University Health Network, Princess Margaret Hospital, Mount Sinai Hospital and Women's College Hospital, University of Toronto, 610 University Ave., Suite 3-960, Toronto, ON, M5G 2M9, Canada,
Ann Nucl Med. 2014 May;28(4):295-303. doi: 10.1007/s12149-014-0812-2. Epub 2014 Jan 29.
To correlate metabolic response to neoadjuvant chemoradiotherapy (NACR) on FDG-PET/CT using PERCIST-based criteria to pathologic and clinical response, and survival in patients with locally advanced esophageal cancer (LAEC).
Forty-five patients with LAEC underwent PET/CT at baseline and after NACR. Tumors were evaluated using PERCIST (PET response criteria in solid tumors)-based criteria including SUL, SUL tumor/liver ratio, % change in SUL. These parameters were compared to pathology regression grade (PRG), clinical response (including residual or new disease beyond the surgical specimen), and overall survival.
On surgical pathology, there was complete or near-complete regression of tumor in 51.1 %, partial response in 42.2 %, and lack regression in 4.4 %. One patient (2.2 %) had progression of disease on imaging and did not undergo surgical resection. None of the baseline PET parameters had significant correlation to pathology regression grade or clinical response. On follow-up, a positive correlation was found between post-therapy SUL ratio, %∆ SUL and %∆ SUL ratio and clinical response (p = 0.025, 0.035, 0.030, respectively). A weak correlation was found between post-therapy SUL ratio to PRG (p = 0.049). A strong correlation was found between the metabolic response score and PRG (p = 0.002) as well as between metabolic response and clinical response (p < 0.001).
PERCIST-based metabolic response assessment to NACR in LAEC may correlate with clinical outcome and survival.
使用基于PERCIST的标准，将氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（FDG-PET/CT）上的新辅助放化疗（NACR）代谢反应与局部晚期食管癌（LAEC）患者的病理及临床反应和生存率相关联。
45例LAEC患者在基线期及NACR后接受了PET/CT检查。使用基于实体瘤PET反应标准（PERCIST）的标准对肿瘤进行评估，包括标准化摄取值（SUL）、SUL肿瘤/肝脏比值、SUL的变化百分比。将这些参数与病理消退分级（PRG）、临床反应（包括手术标本以外的残留或新发病变）及总生存率进行比较。
手术病理显示，51.1%的患者肿瘤完全或近乎完全消退，42.2%部分缓解，4.4%无消退。1例患者（2.2%）影像学检查显示疾病进展，未接受手术切除。基线期的PET参数与病理消退分级或临床反应均无显著相关性。随访发现，治疗后SUL比值、SUL变化百分比及SUL变化比值与临床反应呈正相关（分别为p = 0.025、0.035、0.030）。治疗后SUL比值与PRG呈弱相关（p = 0.049）。代谢反应评分与PRG之间以及代谢反应与临床反应之间呈强相关（分别为p = 0.002和p < 0.001）。
基于PERCIST对LAEC患者NACR的代谢反应评估可能与临床结局和生存率相关。
