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Monitoring of Tumor Response to Neoadjuvant Radio-Chemotherapy of esophageal Carcinoma by F-18-FDG-PeT

Oncology and Translational Medicine 2004年第4期 64-69页

作者： Peter Theissen,Paul M. Schneider,Stephan e. Baldus,Alexandra Jost,Markus Dietlein,Rolf P. Mller,Arnulf H. Hlscher,Harald Schicha Department of Nuclear Medicine University of Cologne Department of Visceral- and Vascular Surgery University of Cologne Department of Pathology University of Cologne Department of Nuclear Medicine University of Cologne Department of Nuclear Medicine University of Cologne Department of Radiation therapy University of Cologne Department of Visceral- and Vascular Surgery University of Cologne Department of Nuclear Medicine University of Cologne Cologne Germany Cologne Germany Cologne Germany Cologne GermanyDepartment of Visceral- and Vascular Surgery University of CologneCologne Germany Cologne Germany Cologne Germany Cologne Germany Cologne Germany

Introduction: For clinical assessment of neoadjuvant radiochemotherapy of esophageal cancer reliable in-vivo methods are necessary. Therefore, the capabilities of F-18-Fluorodesoxyglucose-PeT in comparison to histomorphological grading of tumor regression were studied. Methods: In 33 patients with locally advanced esophageal carcinoma (uT3, uN0-1, cM0) F-18-FDG-PeT was performed before and 2 weeks after radiochemotherapy. All tumors were resected by transthoracic en-bloc esophagectomy 3–4 weeks after induction therapy. A subgroup of 11 patients underwent weekly PeT scan during neoadjuvant therapy. PeT was performed in a dedicated scanner 1.3 h after administration of 370 MBq F-18-FDG. Data analysis based on maximum SUV data derived from individual regions of interest in pre- and posttherapeutic images. PeT data were compared to histomorphological grading parameters for tumor regression whithin the resected tissues. Results: The comparison of histopathological tumor regression after neoadjuvant therapy and PeT SUV di?erences showed a signi?cant χ2 P -value of 0.006. There was a signi?cant decrease 五笔字型计算机汉字输入技术 of the SUV data from 9.1±3.5 to 4.3±1.9 (P therapy responders SUV was diminished by 59 % and in non-responders by 34 %. Longitudinal SUV measurement during neoadjuvant therapy showed a strong SUV decrease already after one and two weeks (P =0.021 and 0.003). Conclusion: The recent data of the FDG-PeT follow-up after neoadjuvant therapy show that PeT is able to predict therapy response. Longitudinal PeT data advocate that it may be possible to recognize response also very early during radiochemotherapy.

关键词： PeT esophageal cancer therapy response histomorphological regression early therapy e?ect

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