Response Evaluation after Neoadjuvant Chemoradiation by Positron Emission Tomography-Computed Tomography for Esophageal Squamous Cell Carcinoma / Journal of the Korean Cancer Association, 대한암학회지

ABSTRACT

PURPOSE: Parameters of positron emission tomography-computed tomography (PET-CT) were compared with the results of histopathologic examination in order to determine which can provide an objective indication of response after neoadjuvant chemoradiation for treatment of thoracic esophageal squamous cell carcinoma (SCC). MATERIALS AND METHODS: Between August 2003 and January 2010, data on 25 patients who underwent neoadjuvant chemoradiation and subsequent resection for treatment of esophageal SCC were retrospectively reviewed. Changes in maximum standardized uptake value (DeltaSUVmax), metabolic tumor volume (DeltaMTV), and total lesion glycolysis (DeltaTLG) were analyzed by comparison with the histopathologic findings. RESULTS: Pathologic complete remission (CR) for the main tumor was achieved in 11 patients. Postradiation esophagitis was observed in 10 patients. DeltaSUVmax of the main tumor was significantly greater in the CR group than in the partial response (PR) group (p=0.039), while DeltaMTV and DeltaTLG of the main tumor were not (p=0.141 and p=0.349, respectively). The cut-off DeltaSUVmax value for CR was estimated as 72.1%, indicating significantly better accuracy than visual interpretation (p=0.045). Of the 48 involved lymph nodes, DeltaSUVmax and DeltaMTV of lymph nodes were significantly greater in the CR group than in the PR group (p=0.045 and p=0.014, respectively), while DeltaTLG was not (p=0.063). The cut-off value of DeltaSUVmax for prediction of CR in lymph nodes was calculated as 50.67%. CONCLUSION: PET-CT could be used for prediction of response to neoadjuvant treatment in thoracic esophageal SCC. DeltaSUVmax may be a more significant predictor for CR after neoadjuvant chemoradiation than DeltaTLG and DeltaMTV.