TY - JOUR
T1 - Predicting the effects of chemoradiotherapy for squamous cell carcinoma of the esophagus by induction chemotherapy response assessed by positron emission tomography
T2 - Toward PET-response-guided selection of chemoradiotherapy or esophagectomy
AU - Ishihara, Ryu
AU - Yamamoto, Sachiko
AU - Iishi, Hiroyasu
AU - Nagai, Kengo
AU - Matui, Fumi
AU - Kawada, Natsuko
AU - Ohta, Takashi
AU - Kanzaki, Hiromitsu
AU - Hanafusa, Masao
AU - Hanaoka, Noboru
AU - Takeuchi, Yoji
AU - Higashino, Koji
AU - Uedo, Noriya
AU - Sugimoto, Naotoshi
AU - Kawaguchi, Yoshifumi
AU - Nishiyama, Kinji
AU - Motoori, Masaaki
AU - Yano, Masahiko
AU - Hosoki, Takuya
N1 - Funding Information:
The authors gratefully acknowledge the assistance of the PET technicians and staff of the Morinomiya Clinic. This work was supported in part by the Osaka Foundation for the Prevention of Cancer and Cardiovascular Diseases.
PY - 2012/6
Y1 - 2012/6
N2 - Background We have developed a treatment protocol for esophageal cancer involving a single course of induction chemotherapy followed by chemoradiotherapy. This study aimed to determine if it was possible to predict the effects of chemoradiotherapy on the basis of the response to induction chemotherapy, assessed by positron emission tomography (PET). Methods Sixteen patients with Stage II-IVA esophageal cancer were treated using this protocol from April 2007 to July 2010. Chemotherapy involved a fluorouracil and platinum-based combination regimen. All patients received PET scans before and 12-24 days after the beginning of induction chemotherapy. Associations between the response to induction chemotherapy assessed by PET and the effects of chemoradiotherapy were evaluated. Results Induction chemotherapy followed by chemoradiotherapy resulted in complete response (CR) in 10 of the 16 patients. The reduction in maximum standardized uptake value (SUVmax) was 58 ± 12% in patients with CR (n = 10), compared with 14 ± 16% in patients without CR (n = 6) (P < 0.0001). Using a cut-off value of 55% for SUVmax reduction rate, eight of 10 cancers with CR and six of six cancers without CR were correctly identified, providing a sensitivity and specificity of 80 and 100%, respectively. The overall 1-year survival rates for patients with an SUVmax reduction rate >55% (responders) were 100%, compared with 60% for patients with an SUVmax reduction rate ≤55% (non-responders), respectively. Conclusions The response to a single course of induction therapy assessed by PET was significantly associated with the effects of chemoradiotherapy.
AB - Background We have developed a treatment protocol for esophageal cancer involving a single course of induction chemotherapy followed by chemoradiotherapy. This study aimed to determine if it was possible to predict the effects of chemoradiotherapy on the basis of the response to induction chemotherapy, assessed by positron emission tomography (PET). Methods Sixteen patients with Stage II-IVA esophageal cancer were treated using this protocol from April 2007 to July 2010. Chemotherapy involved a fluorouracil and platinum-based combination regimen. All patients received PET scans before and 12-24 days after the beginning of induction chemotherapy. Associations between the response to induction chemotherapy assessed by PET and the effects of chemoradiotherapy were evaluated. Results Induction chemotherapy followed by chemoradiotherapy resulted in complete response (CR) in 10 of the 16 patients. The reduction in maximum standardized uptake value (SUVmax) was 58 ± 12% in patients with CR (n = 10), compared with 14 ± 16% in patients without CR (n = 6) (P < 0.0001). Using a cut-off value of 55% for SUVmax reduction rate, eight of 10 cancers with CR and six of six cancers without CR were correctly identified, providing a sensitivity and specificity of 80 and 100%, respectively. The overall 1-year survival rates for patients with an SUVmax reduction rate >55% (responders) were 100%, compared with 60% for patients with an SUVmax reduction rate ≤55% (non-responders), respectively. Conclusions The response to a single course of induction therapy assessed by PET was significantly associated with the effects of chemoradiotherapy.
KW - Chemoradiotherapy
KW - Complete response
KW - Esophageal cancer
KW - Positron emission tomography
KW - Squamous-cell type
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U2 - 10.1007/s10147-011-0278-3
DO - 10.1007/s10147-011-0278-3
M3 - Article
C2 - 21735356
AN - SCOPUS:84862842680
SN - 1341-9625
VL - 17
SP - 225
EP - 232
JO - International Journal of Clinical Oncology
JF - International Journal of Clinical Oncology
IS - 3
ER -
