Positron emission tomography and pathological evidence of response to neoadjuvant therapy in adenocarcinoma of the esophagus.

Positron emission tomography and pathological evidence of response to neoadjuvant therapy in adenocarcinoma of the esophagus. Research Abstract Details 

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Positron emission tomography and pathological evidence of response to neoadjuvant therapy in adenocarcinoma of the esophagus. Abstract Text:

B M Smithers,G C Couper,J M Thomas,D Wong,D C Gotley,I Martin,J A Harvey,D B Thomson,E T Walpole,N Watts,B H Burmeister,

Our aim was to determine if fluorodeoxyglucose positron emission tomography (FDG-PET) could be correlated with a pathological response in patients with esophageal adenocarcinoma receiving neoadjuvant chemotherapy and/or chemoradiation therapy. Patients with resectable, histologically proven adenocarcinoma of the esophagus were entered in the study. Preoperative chemotherapy comprised two cycles of cisplatin and 5-fluorouracil. Radiation therapy commenced with the second cycle on day 22. FDG-PET images were obtained pre-treatment and on completion of intended neo-adjuvant treatment. Quantification was achieved by the calculation of both standardized uptake values (SUV) and tumor/liver ratios (TLR). Evidence of histopathological response was identified according to the Mandard tumor regression scoring system. There were 45 patients, 22 receiving neoadjuvant chemotherapy and 23 chemoradiation therapy. Forty patients underwent surgical resection. Seven patients (16%) had a histopathological response. The mean percentage change in SUV in the histological responders group was -56.8% (SD 29) and in the non-responders -27.8% (SD 32.1) (P = 0.035). The mean percentage change in TLR was -49.1% (SD 44.8) in the responders and in the non-responders -27.3% (SD 31.3) (P = 0.128). There was no difference between the two methods of assessment, however there was less variation with SUV. There was no correlation between the FDG-PET response and the histopathological response. Presently an FDG-PET scan performed 3-6 weeks after neoadjuvant therapy for adenocarcinoma of the esophagus should not be used as a marker of the potential result of the treatment. The optimal timing of a second FDG-PET remains unclear.

Positron emission tomography and pathological evidence of response to neoadjuvant therapy in adenocarcinoma of the esophagus. Publishing Authors By Initials

BM Smithers,GC Couper,JM Thomas,D Wong,DC Gotley,I Martin,JA Harvey,DB Thomson,ET Walpole,N Watts,BH Burmeister,

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Positron emission tomography and pathological evidence of response to neoadjuvant therapy in adenocarcinoma of the esophagus. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Diseases of the esophagus : official journal of th

VOLUME: 21

Page Numbers: 151-8

Journal Abbreviation: Dis. Esophagus

ISSN: 1442-2050

DAY: 13

MONTH: 02

YEAR: 2008

Positron emission tomography and pathological evidence of response to neoadjuvant therapy in adenocarcinoma of the esophagus. Information

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LANGUAGE: eng

NlmUniqueID: 8809160

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AFFILIATION: Department of Surgery, University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia. m.smithers@.uq.edu.au

Country: Australia

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MEDLINETA: Dis Esophagus

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