Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.

OBJECTIVES: Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response pr...

Full description

Bibliographic Details
Main Authors: Gillies, R, Middleton, MR, Blesing, C, Patel, K, Warner, N, Marshall, R, Maynard, N, Bradley, K, Gleeson, F
Format: Journal article
Language:English
Published: 2012
_version_ 1826275492806787072
author Gillies, R
Middleton, MR
Blesing, C
Patel, K
Warner, N
Marshall, R
Maynard, N
Bradley, K
Gleeson, F
author_facet Gillies, R
Middleton, MR
Blesing, C
Patel, K
Warner, N
Marshall, R
Maynard, N
Bradley, K
Gleeson, F
author_sort Gillies, R
collection OXFORD
description OBJECTIVES: Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response predicts pathological response to a standardised neoadjuvant chemotherapy regimen within a prospective clinical trial. METHODS: Consecutive patients staged with potentially curable oesophageal cancer who underwent treatment within a non-randomised clinical trial were included. A standardised chemotherapy regimen (two cycles of oxaliplatin and 5-fluorouracil) was used. PET/CT was performed before chemotherapy and repeated 24-28 days after the start of cycle 2. RESULTS: Forty-eight subjects were included: mean age 65 years; 37 male. Using the median percentage reduction in SUV(max) (42%) to define metabolic response, pathological response was seen in 71% of metabolic responders (17/24) compared with 33% of non-responders (8/24; P = 0.009, sensitivity 68%, specificity 70%). Pathological response was seen in 81% of subjects with a complete metabolic response (13/16) compared with 38% of those with a less than complete response (12/32; P = 0.0042, sensitivity 52%, specificity 87%). There was no significant histology-based effect. CONCLUSIONS: There was a significant association between metabolic response and pathological response; however, accuracy in predicting pathological response was relatively low.
first_indexed 2024-03-06T22:59:32Z
format Journal article
id oxford-uuid:6197f85e-faeb-4810-9e69-c5aec76ff5e5
institution University of Oxford
language English
last_indexed 2024-03-06T22:59:32Z
publishDate 2012
record_format dspace
spelling oxford-uuid:6197f85e-faeb-4810-9e69-c5aec76ff5e52022-03-26T18:01:06ZMetabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6197f85e-faeb-4810-9e69-c5aec76ff5e5EnglishSymplectic Elements at Oxford2012Gillies, RMiddleton, MRBlesing, CPatel, KWarner, NMarshall, RMaynard, NBradley, KGleeson, FOBJECTIVES: Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response predicts pathological response to a standardised neoadjuvant chemotherapy regimen within a prospective clinical trial. METHODS: Consecutive patients staged with potentially curable oesophageal cancer who underwent treatment within a non-randomised clinical trial were included. A standardised chemotherapy regimen (two cycles of oxaliplatin and 5-fluorouracil) was used. PET/CT was performed before chemotherapy and repeated 24-28 days after the start of cycle 2. RESULTS: Forty-eight subjects were included: mean age 65 years; 37 male. Using the median percentage reduction in SUV(max) (42%) to define metabolic response, pathological response was seen in 71% of metabolic responders (17/24) compared with 33% of non-responders (8/24; P = 0.009, sensitivity 68%, specificity 70%). Pathological response was seen in 81% of subjects with a complete metabolic response (13/16) compared with 38% of those with a less than complete response (12/32; P = 0.0042, sensitivity 52%, specificity 87%). There was no significant histology-based effect. CONCLUSIONS: There was a significant association between metabolic response and pathological response; however, accuracy in predicting pathological response was relatively low.
spellingShingle Gillies, R
Middleton, MR
Blesing, C
Patel, K
Warner, N
Marshall, R
Maynard, N
Bradley, K
Gleeson, F
Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.
title Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.
title_full Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.
title_fullStr Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.
title_full_unstemmed Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.
title_short Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer.
title_sort metabolic response at repeat pet ct predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer
work_keys_str_mv AT gilliesr metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT middletonmr metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT blesingc metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT patelk metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT warnern metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT marshallr metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT maynardn metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT bradleyk metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer
AT gleesonf metabolicresponseatrepeatpetctpredictspathologicalresponsetoneoadjuvantchemotherapyinoesophagealcancer