18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients

Eur J Cancer. 2015 Nov;51(17):2545-52. doi: 10.1016/j.ejca.2015.07.044. Epub 2015 Aug 28.


Introduction: The purpose of this study was to evaluate if a baseline, an interim or a post-chemoradiation (CTRT) 18-fluorodeoxy-glucose positron emission computed tomography (18F-FDG PET/CT) studies could provide information on pathologic response to CTRT and overall survival (OS).

Materials and methods: Thirty-one patients with histologically proven adenocarcinoma or squamous cell carcinoma of the oesophagus, fit for trimodality therapy were prospectively enrolled. Most were men (93.5%), and had a stage III cancer (74.2%). Chemotherapy consisted of oxaliplatin/5-fluorouracil (45.2%) and taxane/5-fluorouracil (54.8%). All patients underwent a baseline, an interim (performed 12 ± 2 days after the onset of CTRT) and a post-CTRT 18F-FDG PET/CT study. The 18F-FDG PET/CT variables evaluated were at baseline, interim and post-CTRT studies maximum standardised uptake value (SUV max) and total lesion glycolysis (TLG). Clinical and 18F-FDG PET/CT parameters were correlated with pathologic complete response (pathCR) and OS.

Results: Among the 31 patients studied, 61.3% achieved a clinical complete response (cCR) and 87.1% had surgery. The median OS was 35.1 months (95% confidence interval (CI): 19.9-NA). PathCR rate was 22.2%. There was only a marginal association between cCR and pathCR (p = 0.06). None of the other variables was predictive of pathCR. There was association between OS and baseline TLG (p = 0.03) at the optimal cutoff TLG value of 75.15. Additionally, TLG and ΔTLG post-CTRT were also associated with OS (p = 0.01 and 0.03, respectively).

Conclusion: None of the PET parameters is predictive of pathCR but TLG at baseline and post-CTRT are prognostic of OS.

Trial registration: ClinicalTrials.gov NCT00833625.

Keywords: 18F-FDG PET/CT; Chemoradiation; Early response evaluation; Gastroesophageal cancer; Pathologic response.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bridged-Ring Compounds / administration & dosage
  • Chemoradiotherapy / methods
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / therapy*
  • Female
  • Fluorodeoxyglucose F18
  • Fluorouracil / administration & dosage
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Organoplatinum Compounds / administration & dosage
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Oxaliplatin
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Remission Induction
  • Taxoids / administration & dosage
  • Tomography, X-Ray Computed / methods*


  • Bridged-Ring Compounds
  • Organoplatinum Compounds
  • Taxoids
  • Oxaliplatin
  • Fluorodeoxyglucose F18
  • taxane
  • Fluorouracil

Associated data

  • ClinicalTrials.gov/NCT00833625