Early metabolic response to chemoradiotherapy by interim FDG PET/CT is associated with better overall survival and histological response in esophageal cancers

Dig Liver Dis. 2019 Jun;51(6):887-893. doi: 10.1016/j.dld.2018.12.006. Epub 2018 Dec 23.


Background: Early assessment of response to neoadjuvant chemoradiotherapy (CRT) is crucial in determining the most suitable treatment strategy in locally advanced oesophageal cancer (LAEC).

Aims: We evaluated the impact of early metabolic response during CRT on overall survival (OS) and histological response.

Methods: Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment and during CRT after 20 Gy.

Results: 116 patients (Male: 66.4%, Median age: 63; squamous cell carcinomas (SCC): 70%) met inclusion criteria. Median OS was 21.7 months. There was a significant positive correlation between interim metabolic response and OS. In multivariate analysis, only metabolic response using the 50% cut-off value remained significantly associated with OS (IC95% = 0.28-0.73; p = 0.001). In this statistical analysis, surgery (p = 0.007) and T stage (p = 0.023) were also correlated with OS. There was a significant correlation between early metabolic response and local recurrence (Chi-squared test p = 0.0001).

Conclusions: Early metabolic response using FDG PET/CT is associated with better OS, disease-free survival, local control and pathological response in patients treated by CRT for LAEC.

Keywords: Cancer; Local recurrence; Oesophageal; PET; Prognosis; Radiotherapy.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy*
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / mortality*
  • Esophageal Neoplasms / therapy
  • Female
  • Fluorodeoxyglucose F18
  • France / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Survival Analysis
  • Treatment Outcome
  • Young Adult


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18