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PET/CT planning during chemoradiotherapy for esophageal cancer
Radiation Oncology Journal ; : 31-42, 2014.
Article in English | WPRIM | ID: wpr-178909
ABSTRACT

PURPOSE:

To evaluate the usefulness of positron emission tomography/computed tomography (PET/CT) for field modification during radiotherapy in esophageal cancer. MATERIALS AND

METHODS:

We conducted a retrospective study on 33 patients that underwent chemoradiotherapy (CRT). Pathologic findings were squamous cell carcinoma in 32 patients and adenocarcinoma in 1 patient. All patients underwent PET/CT scans before and during CRT (after receiving 40 Gy and before a 20 Gy boost dose). Response evaluation was determined by PET/CT using metabolic tumor volume (MTV), total glycolytic activity (TGA), MTV ratio (rMTV) and TGA ratio (rTGA), or determined by CT. rMTV and rTGA were reduction ratio of MTV and TGA between before and during CRT, respectively.

RESULTS:

Significant decreases in MTV (MTV2.5 mean 70.09%, p < 0.001) and TGA (TGA2.5 mean 79.08%, p<0.001) were found between before and during CRT. Median rMTV2.5 was 0.299 (range, 0 to 0.98) and median rTGA2.5 was 0.209 (range, 0 to 0.92). During CRT, PET/CT detected newly developed distant metastasis in 1 patient, and this resulted in a treatment strategy change. At a median 4 months (range, 0 to 12 months) after completion of CRT, 8 patients (24.2%) achieved clinically complete response, 11 (33.3%) partial response, 5 (15.2%) stable disease, and 9 (27.3%) disease progression. SUVmax (p = 0.029), rMTV50% (p = 0.016), rMTV75% (p = 0.023) on intra-treatment PET were found to correlate with complete clinical response.

CONCLUSION:

PET/CT during CRT can provide additional information useful for radiotherapy planning and offer the potential for tumor response evaluation during CRT. rMTV50% during CRT was found to be a useful predictor of clinical response.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Radiotherapy / Esophageal Neoplasms / Carcinoma, Squamous Cell / Adenocarcinoma / Retrospective Studies / Disease Progression / Tumor Burden / Electrons / Chemoradiotherapy / Positron Emission Tomography Computed Tomography Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Radiation Oncology Journal Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Radiotherapy / Esophageal Neoplasms / Carcinoma, Squamous Cell / Adenocarcinoma / Retrospective Studies / Disease Progression / Tumor Burden / Electrons / Chemoradiotherapy / Positron Emission Tomography Computed Tomography Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Radiation Oncology Journal Year: 2014 Type: Article