Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation

Abstract Background To evaluate the prognostic value of metabolic parameters of pre-treatment and interim 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for overall survival (OS) of esophageal cancer(EC) patients undergoing (chemo-) radiotherapy. Methods A retrospective analysis of...

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Main Authors: Yimin Li, Sebastian Zschaeck, Qin Lin, Sijia Chen, Lili Chen, Hua Wu
Format: Article
Language:English
Published: BMC 2019-02-01
Series:Radiation Oncology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13014-019-1236-x
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author Yimin Li
Sebastian Zschaeck
Qin Lin
Sijia Chen
Lili Chen
Hua Wu
author_facet Yimin Li
Sebastian Zschaeck
Qin Lin
Sijia Chen
Lili Chen
Hua Wu
author_sort Yimin Li
collection DOAJ
description Abstract Background To evaluate the prognostic value of metabolic parameters of pre-treatment and interim 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for overall survival (OS) of esophageal cancer(EC) patients undergoing (chemo-) radiotherapy. Methods A retrospective analysis of 134 patients with pathology confirmed squamous cell EC treated between July 2009 and October 2013 in our hospital was performed. Inclusion criteria for this study were curative intended radiotherapy and availability of pre-treatment and interim 18F-FDG PET. 18F-FDG PET/CT scans were acquired before treatment and after 40 Gray (Gy) of radiotherapy. Maximum standard uptake value (SUVmax), metabolic tumor volume(MTV), total lesion glycolysis (TLG), and the percentual changes during both PET scans were recorded. The parameters were named as SUVmax1,MTV1,TLG1,SUVmax2,MTV2,TLG2,△SUVmax,△MTV and △TLG. The receiver operating characteristic curve (ROC) was used to analyze the relationship between metabolic parameters and OS, survival analysis was carried out by Kaplan-Meier and Cox regression analysis. Results Univariate survival analysis showed that SUVmax2、MTV1、△MTV、TLG1、TLG2 and △TLG were associated with OS. Based on the largest Youden index of ROC curves, patients with SUVmax2 < 7.8, MTV1 < 10.5, △MTV < 0.075, TLG1 < 59.8, TLG2 < 44.3 and △TLG < 0.27 tended to live longer. Stratified for these parameters, the estimated median survival time were 27.9 months (m) vs 9.8 m, 36.9 m vs 11.3 m, 41.6 m vs 12 m, 48.9 m vs 14.3 m, 32.6 m vs 13.2 m, and 41.6 m vs 14.5 m. Cox multi-factor regression analyses revealed SUVmax2 as an independent prognostic factor for OS complementary to TNM staging and the length of primary tumor. Conclusions Sequential 18F-FDG PET/CT metabolic parameters bear important prognostic value for OS of EC patients. 18F-FDG PET/CT scan before treatment and during chemoradiotherapy seems helpful to evaluate the effect of chemoradiotherapy, guide clinical decisions and provide patients with personalized treatment.
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spelling doaj.art-9e75ef2145eb4775a288cec84335d37f2022-12-22T02:43:21ZengBMCRadiation Oncology1748-717X2019-02-011411910.1186/s13014-019-1236-xMetabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiationYimin Li0Sebastian Zschaeck1Qin Lin2Sijia Chen3Lili Chen4Hua Wu5Department of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen UniversityDepartment of Radiation Oncology, Charité Universitätsmedizin BerlinDepartment of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen UniversityDepartment of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen UniversityDepartment of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen UniversityDepartment of Nuclear Medicine, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen University/Southern Fujian PET CenterAbstract Background To evaluate the prognostic value of metabolic parameters of pre-treatment and interim 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for overall survival (OS) of esophageal cancer(EC) patients undergoing (chemo-) radiotherapy. Methods A retrospective analysis of 134 patients with pathology confirmed squamous cell EC treated between July 2009 and October 2013 in our hospital was performed. Inclusion criteria for this study were curative intended radiotherapy and availability of pre-treatment and interim 18F-FDG PET. 18F-FDG PET/CT scans were acquired before treatment and after 40 Gray (Gy) of radiotherapy. Maximum standard uptake value (SUVmax), metabolic tumor volume(MTV), total lesion glycolysis (TLG), and the percentual changes during both PET scans were recorded. The parameters were named as SUVmax1,MTV1,TLG1,SUVmax2,MTV2,TLG2,△SUVmax,△MTV and △TLG. The receiver operating characteristic curve (ROC) was used to analyze the relationship between metabolic parameters and OS, survival analysis was carried out by Kaplan-Meier and Cox regression analysis. Results Univariate survival analysis showed that SUVmax2、MTV1、△MTV、TLG1、TLG2 and △TLG were associated with OS. Based on the largest Youden index of ROC curves, patients with SUVmax2 < 7.8, MTV1 < 10.5, △MTV < 0.075, TLG1 < 59.8, TLG2 < 44.3 and △TLG < 0.27 tended to live longer. Stratified for these parameters, the estimated median survival time were 27.9 months (m) vs 9.8 m, 36.9 m vs 11.3 m, 41.6 m vs 12 m, 48.9 m vs 14.3 m, 32.6 m vs 13.2 m, and 41.6 m vs 14.5 m. Cox multi-factor regression analyses revealed SUVmax2 as an independent prognostic factor for OS complementary to TNM staging and the length of primary tumor. Conclusions Sequential 18F-FDG PET/CT metabolic parameters bear important prognostic value for OS of EC patients. 18F-FDG PET/CT scan before treatment and during chemoradiotherapy seems helpful to evaluate the effect of chemoradiotherapy, guide clinical decisions and provide patients with personalized treatment.http://link.springer.com/article/10.1186/s13014-019-1236-xEsophageal cancer18F-FDG PET/CTChemoradiotherapy
spellingShingle Yimin Li
Sebastian Zschaeck
Qin Lin
Sijia Chen
Lili Chen
Hua Wu
Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation
Radiation Oncology
Esophageal cancer
18F-FDG PET/CT
Chemoradiotherapy
title Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation
title_full Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation
title_fullStr Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation
title_full_unstemmed Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation
title_short Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation
title_sort metabolic parameters of sequential 18f fdg pet ct predict overall survival of esophageal cancer patients treated with chemo radiation
topic Esophageal cancer
18F-FDG PET/CT
Chemoradiotherapy
url http://link.springer.com/article/10.1186/s13014-019-1236-x
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