CC BY 4.0 · World J Nucl Med 2023; 22(03): 226-233
DOI: 10.1055/s-0043-1774417
Original Article

The Prognostic Value of Sequential 18F-FDG PET/CT Metabolic Parameters in Outcomes of Upper-Third Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Chemoradiotherapy

Le Ngoc Ha*
1   Department of Nuclear Medicine, Hospital 108, Hanoi, Vietnam
,
Nguyen Dinh Chau*
2   Department of Radiation Oncology and Radiosurgery, Hospital 108, Hanoi, Vietnam
,
Bui Quang Bieu
2   Department of Radiation Oncology and Radiosurgery, Hospital 108, Hanoi, Vietnam
,
1   Department of Nuclear Medicine, Hospital 108, Hanoi, Vietnam
› Institutsangaben

Funding No funding.

Abstract

Objective The aim of this study is to determine prognostic values of sequential 18F-FDG PET/CT metabolic parameters in locally advanced esophageal squamous cell carcinoma (ESCC) patients treated with definitive chemoradiotherapy.

Materials and Methods Forty locally advanced ESCC patients treated with definitive chemoradiotherapy (dCRT) who received pre-treatment 18F-FDG PET/CT (PET1) and 3-months post-treatment 18F-FDG PET/CT (PET2) were enrolled in the prospective study. 18F-FDG PET parameters of the primary tumor including maximum and mean standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated on PET delineated primary tumor. Using Kaplan-Meier curves to estimated overall survival (OS), progression-free survival (PFS), and local-regional control (LRC). Cox regression analysis was performed to find significant prognostic factors for survival.

Results With a median follow-up of 13.5 months, the 4-year OS, PFS, and LRC rates were 67.3%, 52.6%, and 53.4% respectively. Patients with MTV 2 > 5.7 had lower OS, PFS, and LRC rates than the lower MTV 2 group (p < 0.05). Univariate Cox regression analysis showed that MTV2 was a significant prognostic factor for OS, PFS, and LRC (p < 0.05).

Conclusion MTV parameter of sequential 18F-FDG PET/CT could be used as a prognostic factor for OS, PFS, and LRC in locally advanced ESCC patients treated with dCRT.

Authors' Contribution

Le Ngoc Ha, Nguyen Dinh Chau, and Mai Hong Son were involved in writing of the manuscript. Nguyen Dinh Chau helped in data collection. Mai Hong Son, Le Ngoc Ha, and Nguyen Dinh Chau helped in editing and submission of the manuscript. All the authors contributed equally to this paper.


Ethical Approval

This study was approved by the Institutional Review Board of Central Military Hospital 108 (approval No. 165/QD-V108).


Availability of Data and Materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.


* These authors contributed equally to the study and retain the first authorship.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
13. September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Sung H, Ferlay J, Siegel RL. et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71 (03) 209-249
  • 2 Ding X, Zhang J, Li B. et al. A meta-analysis of lymph node metastasis rate for patients with thoracic oesophageal cancer and its implication in delineation of clinical target volume for radiation therapy. Br J Radiol 2012; 85 (1019) e1110-e1119
  • 3 Ajani JA, Barthel JS, Bentrem DJ. et al; National Comprehensive Cancer Network. Esophageal and esophagogastric junction cancers. J Natl Compr Canc Netw 2011; 9 (08) 830-887
  • 4 Ando N, Kato H, Igaki H. et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol 2012; 19 (01) 68-74
  • 5 Burmeister BH, Dickie G, Smithers BM, Hodge R, Morton K. Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy. Arch Otolaryngol Head Neck Surg 2000; 126 (02) 205-208
  • 6 Kato K, Muro K, Minashi K. et al; Gastrointestinal Oncology Study Group of the Japan Clinical Oncology Group (JCOG). Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for Stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys 2011; 81 (03) 684-690
  • 7 van Hagen P, Hulshof MCCM, van Lanschot JJB. et al; CROSS Group. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 2012; 366 (22) 2074-2084
  • 8 Kumar P, Damle NA, Bal C. Role of F18-FDG PET/CT in the staging and restaging of esophageal cancer: a comparison with CECT. Indian J Surg Oncol 2011; 2 (04) 343-350
  • 9 Muijs CT, Beukema JC, Pruim J. et al. A systematic review on the role of FDG-PET/CT in tumour delineation and radiotherapy planning in patients with esophageal cancer. Radiother Oncol 2010; 97 (02) 165-171
  • 10 Bruzzi JF, Munden RF, Truong MT. et al. PET/CT of esophageal cancer: its role in clinical management. Radiographics 2007; 27 (06) 1635-1652
  • 11 Gopal A, Xi Y, Subramaniam RM, Pinho DF. Intratumoral metabolic heterogeneity and other quantitative 18F-FDG PET/CT parameters for prognosis prediction in esophageal cancer. Radiol Imaging Cancer 2020; 3 (01) e200022
  • 12 Han S, Kim YJ, Woo S, Suh CH, Lee JJ. Prognostic value of volumetric parameters of pretreatment 18F-FDG PET/CT in esophageal cancer: a systematic review and meta-analysis. Clin Nucl Med 2018; 43 (12) 887-894
  • 13 Shum WY, Ding HJ, Liang JA, Yen KY, Chen SW, Kao CH. Use of pretreatment metabolic tumor volumes on PET-CT to predict the survival of patients with squamous cell carcinoma of esophagus treated by curative surgery. Anticancer Res 2012; 32 (09) 4163-4168
  • 14 Atsumi K, Nakamura K, Abe K. et al. Prediction of outcome with FDG-PET in definitive chemoradiotherapy for esophageal cancer. J Radiat Res (Tokyo) 2013; 54 (05) 890-898
  • 15 Rizk NP, Tang L, Adusumilli PS. et al. Predictive value of initial PET-SUVmax in patients with locally advanced esophageal and gastroesophageal junction adenocarcinoma. J Thorac Oncol 2009; 4 (07) 875-879
  • 16 Suzuki A, Xiao L, Hayashi Y. et al. Prognostic significance of baseline positron emission tomography and importance of clinical complete response in patients with esophageal or gastroesophageal junction cancer treated with definitive chemoradiotherapy. Cancer 2011; 117 (21) 4823-4833
  • 17 Li Y, Zschaeck S, Lin Q, Chen S, Chen L, Wu H. Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation. Radiat Oncol 2019; 14 (01) 35
  • 18 Wieder HA, Ott K, Lordick F. et al. Prediction of tumor response by FDG-PET: comparison of the accuracy of single and sequential studies in patients with adenocarcinomas of the esophagogastric junction. Eur J Nucl Med Mol Imaging 2007; 34 (12) 1925-1932
  • 19 Chang S, Koo PJ, Kwak JJ, Kim SJ. Changes in total lesion glycolysis evaluated by repeated F-18 FDG PET/CT as prognostic factor in locally advanced esophageal cancer patients treated with preoperative chemoradiotherapy. Oncology 2016; 90 (02) 97-102
  • 20 Hatt M, Visvikis D, Albarghach NM, Tixier F, Pradier O, Cheze-le Rest C. Prognostic value of 18F-FDG PET image-based parameters in oesophageal cancer and impact of tumour delineation methodology. Eur J Nucl Med Mol Imaging 2011; 38 (07) 1191-1202
  • 21 Li Y, Lin Q, Wang L. et al. Application of sequential (18)F-FDG PET/CT scans for concurrent chemoradiotherapy of non-surgical squamous cell esophageal carcinoma. J BUON 2014; 19 (02) 517-523
  • 22 Kim N, Cho H, Yun M, Park KR, Lee CG. Prognostic values of mid-radiotherapy 18F-FDG PET/CT in patients with esophageal cancer. Radiat Oncol 2019; 14 (01) 27
  • 23 Omloo JMT, van Heijl M, Hoekstra OS, van Berge Henegouwen MI, van Lanschot JJB, Sloof GW. FDG-PET parameters as prognostic factor in esophageal cancer patients: a review. Ann Surg Oncol 2011; 18 (12) 3338-3352
  • 24 Boellaard R, Delgado-Bolton R, Oyen WJG. et al; European Association of Nuclear Medicine (EANM). FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging 2015; 42 (02) 328-354
  • 25 Larson SM, Erdi Y, Akhurst T. et al. Tumor treatment response based on visual and quantitative changes in global tumor glycolysis using PET-FDG imaging. The visual response score and the change in total lesion glycolysis. Clin Positron Imaging 1999; 2 (03) 159-171
  • 26 Milenović Ž. Application of Mann-Whitney U test in research of professional training of primary school teachers. Metod Obz Horiz 2011; 6 (01) 73-79
  • 27 Grabowski B. “P < 0.05” might not mean what you think: American Statistical Association clarifies p values. J Natl Cancer Inst 2016; 108 (08) djw194
  • 28 Cooper JS, Guo MD, Herskovic A. et al; Radiation Therapy Oncology Group. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). JAMA 1999; 281 (17) 1623-1627
  • 29 Shi A, Liao Z, Allen PK. et al. Long-term survival and toxicity outcomes of intensity modulated radiation therapy for the treatment of esophageal cancer: a large single-institutional cohort study. Adv Radiat Oncol 2017; 2 (03) 316-324
  • 30 Bouvier AM, Binquet C, Gagnaire A, Jouve JL, Faivre J, Bedenne L. Management and prognosis of esophageal cancers: has progress been made?. Eur J Cancer 2006; 42 (02) 228-233
  • 31 Mariette C, Piessen G, Briez N, Triboulet JP. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg 2008; 247 (02) 365-371
  • 32 Vendrely V, Launay V, Najah H, Smith D, Collet D, Gronnier C. Prognostic factors in esophageal cancer treated with curative intent. Dig Liver Dis 2018; 50 (10) 991-996
  • 33 Honing J, Smit JK, Muijs CT. et al. A comparison of carboplatin and paclitaxel with cisplatinum and 5-fluorouracil in definitive chemoradiation in esophageal cancer patients. Ann Oncol 2014; 25 (03) 638-643
  • 34 Cervino AR, Evangelista L, Alfieri R. et al. Positron emission tomography/computed tomography and esophageal cancer in the clinical practice: how does it affect the prognosis?. J Cancer Res Ther 2012; 8 (04) 619-625
  • 35 Hatt M, Majdoub M, Vallières M. et al. 18F-FDG PET uptake characterization through texture analysis: investigating the complementary nature of heterogeneity and functional tumor volume in a multi-cancer site patient cohort. J Nucl Med 2015; 56 (01) 38-44
  • 36 Nakajo M, Jinguji M, Nakabeppu Y. et al. Texture analysis of 18F-FDG PET/CT to predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy. Eur J Nucl Med Mol Imaging 2017; 44 (02) 206-214
  • 37 Tamandl D, Fueger B, Haug A. et al. A diagnostic algorithm that combines quantitative 18F-FDG PET parameters and contrast-enhanced CT improves posttherapeutic locoregional restaging and prognostication of survival in patients with esophageal cancer. Clin Nucl Med 2019; 44 (01) e13-e21
  • 38 Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol 2010; 195 (02) 310-320
  • 39 Koopman D, Jager PL, Slump CH, Knollema S, van Dalen JA. SUV variability in EARL-accredited conventional and digital PET. EJNMMI Res 2019; 9 (01) 106
  • 40 Nahmias C, Wahl LM. Reproducibility of standardized uptake value measurements determined by 18F-FDG PET in malignant tumors. J Nucl Med 2008; 49 (11) 1804-1808
  • 41 Tamal M. Intensity threshold based solid tumour segmentation method for Positron Emission Tomography (PET) images: a review. Heliyon 2020; 6 (10) e05267
  • 42 Kim SJ, Koo PJ, Chang S. Predictive value of repeated F-18 FDG PET/CT parameters changes during preoperative chemoradiotherapy to predict pathologic response and overall survival in locally advanced esophageal adenocarcinoma patients. Cancer Chemother Pharmacol 2016; 77 (04) 723-731
  • 43 Al-Ibraheem A, Abdlkadir AS, Al-Adhami D. et al. The prognostic and diagnostic value of [18F]FDG PET/CT in untreated laryngeal carcinoma. J Clin Med 2023; 12 (10) 3514
  • 44 Berkowitz AC, Halmos B, Cheng H, Huntzinger C, Ohri N. FDG-PET metrics in advanced non-small cell lung cancer (NSCLC): a review and meta-analysis. Clin Transl Imaging
  • 45 Cremonesi M, Garibaldi C, Timmerman R. et al. Interim 18F-FDG-PET/CT during chemo-radiotherapy in the management of oesophageal cancer patients. A systematic review. Radiother Oncol 2017; 125 (02) 200-212
  • 46 Chen H, Li Y, Wu H. et al. 3′-deoxy-3′-[18F]-fluorothymidine PET/CT in early determination of prognosis in patients with esophageal squamous cell cancer: comparison with [18F]-FDG PET/CT. Strahlenther Onkol 2015; 191 (02) 141-152