FDG PET/CT AS PREDICTIVE AND PROGNOSTIC FACTOR IN ESOPHAGEAL CANCER TREATED WITH MULTIMODAL THERAPY
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Abstract
FDG PET/CT AS PREDICTIVE AND PROGNOSTIC FACTOR IN ESOPHAGEAL CANCER TREATED WITH MULTIMODAL THERAPY
Authors: Eleonora Ferrara1, Erinda Puta2, Riccardo Guaschino1, Lucia Turri1, Pierfrancesco Franco1,3, Sergio Gentilli4, Gian Mauro Sacchetti2, Marco Brambilla5, Marco Krengli1,3
1University Hospital Maggiore della Carità, Novara, Italy, Radiation Oncology, NOVARA, Italy; 2University Hospital Maggiore della Carità, Novara, Italy, Nuclear Medicine, NOVARA, Italy; 3University of Piemonte Orientale, Italy, Dept. Of Translational Medicine, NOVARA, Italy; 4University Hospital Maggiore della Carità, Novara, Italy, General Surgery, NOVARA, Italy; 5University Hospital Maggiore della Carità, Novara, Italy, Medical Physics, NOVARA, Italy
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Purpose or Objective
The aim of the present study was to evaluate the role of semiquantitatve PET parameters as possible prognostic and predictive factors in a series of oesophageal carcinomas treated with combined modality treatment.
Material and Methods
A series of 43 patients affected with oesophageal carcinoma and treated with chemo-radiotherapy (CRT) followed by surgery in 20 cases, underwent pre-treatment 18F-FDG PET/CT. Semiquantitaive PET parameters were evaluated including Standardized Uptake Value (SUVmax e SUVmean), Metabolic Tumour Volume (MTV) and Total Lesion Glycolysis (TLG) with isocontour of 41% and 50%. Further variables analysed were gender, primary tumour site, histological type, use of surgery, achievement of a radical resection and chemotherapy regimen. The correlation of all variables with treatment response, loco-regional control (LR control) Overall (OS) and Disease Free (DFS) Survival was evaluated with log-rank, Student’s t- and Chi-squared tests.
Results
As possible predictive factors, pre-treatment PET parameters did not show significant differences between responders (partial or complete response) and non-responders (stable or progressive disease) (p-values ≥0.10). In terms of prognostic factors, MTV correlated with better OS: patients with MTV41 <11.32 cm3 and MTV50 <8.07cm3 (both p-value=0.04) showed better 3-year survival rates (33% vs. 20%). Further factors predicting for better prognosis were the use of surgery and radical resection (R0) (both p-value <0.01). Of note, there was no correlation between MTV and surgery (p-value =0.1).
Conclusion
The present study shows that, among pre-treatment PET parameters, MTV values resulted to be significant prognostic factors for OS, together with the use of surgery and R0 resection.