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Nuklearmedizin 2007; 46(06): 263-270
DOI: 10.3413/nukmed-0074
Prediction of palliative chemotherapy
Schattauer GmbH

Visualisation of metastatic oesophageal and gastric cancer and prediction of clinical response to palliative chemotherapy using 18FDG PET

Frühe Response-Evaluation durch FDG-PET beim metastasierten Ösophagusund Magenkarzinom
S. Lorenzen
1   3rd Department of Internal Medicine (Haematology/Medical Oncology
,
K. Herrmann
2   Department of Nuclear Medicine
,
W. A. Weber
3   Institute for Medical Statistics and Epidemiology
,
H. Wieder
2   Department of Nuclear Medicine
,
M. Hennig
3   Institute for Medical Statistics and Epidemiology
,
K. Ott
4   Department of Surgery, Technical University of Munich
,
R. Bredenkamp
5   Munich Centre for Clinical Studies, Munich, Germany
,
C. Peschel
1   3rd Department of Internal Medicine (Haematology/Medical Oncology
,
M. Schwaiger
2   Department of Nuclear Medicine
,
F. Lordick
1   3rd Department of Internal Medicine (Haematology/Medical Oncology
› Author Affiliations
Further Information

Publication History

Received: 28 November 2006

accepted in revised form: 04 June 2007

Publication Date:
28 December 2017 (online)

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Summary

Aim: This study assessed the value of 18F-deoxyglucose positron emission tomography (FDG-PET) for visualisation and early metabolic response assessment in metastatic gastro-oesophageal cancer. Patients, methods: Twentysix patients who were treated for metastatic disease (20 adenocarcinomas, 6 squamous cell cancers) underwent FDG-PET before and two weeks after the onset of palliative chemotherapy with either oxaliplatin + 5-FU/LV or with docetaxel + capecitabine. PET results were validated according to clinical response based on RECIST criteria. Results: Twenty-four tumours (92%) could be visualised by FDG-PET and were also assessable by a second PET scan at 2 weeks. The 2 tumours that were not detectable by PET were both gastric cancers belonging to the non-intestinal subtype according to Lauren. Median time to progression and overall survival were not significantly different for metabolic responders and non-responders (6.3 vs 5.3 months and 14.1 vs 12.5 months, respectively). Conclusion: In this heterogeneous study population, FDG-PET had a limited accuracy in predicting clinical response. However, the metabolic response prediction was particularly good in the subgroup of patients with oesophageal squamous cell cancer. Therefore, FDG-PET and assessment of cancer therapy clearly merits further investigation in circumscribed patient populations with metastatic disease.

Zusammenfassung

In dieser Studie wurde der Stellenwert von FDG-PET in der frühen Response-Bestimmung beim metastasierten, chemotherapierten Ösophagus- und Magenkarzinom evaluiert. Patienten, Methoden: 26 Patienten mit metastasiertem Ösophagus- oder Magenkarzinom (18 Adenokarzinome, 6 Plattenepithelkarzinome) erhielten eine FDG-PETUntersuchung unmittelbar vor und zwei Wochen nach Beginn einer Oxaliplatin/5-Fluoruracil/Leukovorin- oder Docetaxel/Capecitabine-haltigen Therapie. Ergebnisse: 24 Tumore (92%) konnten mittels PET sowohl initial als auch zwei Wochen nach Therapiebeginn detektiert werden. Die beiden Tumore, die sich im PET nicht darstellen ließen, waren Magenkarzinome vom histologisch intestinalen Typ nach Lauren. PET-Responder und PET-non-Responder unterschieden sich weder signifikant in der medianen Zeit bis zur Progression (6,3 versus 5,3 Monate) noch im Gesamtüberleben (14,1 versus 12,5 Monate). Schlussfolgerung: In der heterogenen Studienpopulation besitzt der Nutzen der FDG-PET-Untersuchung bei der Früh-Response-Evaluation nur eine begrenze Aussagekraft. Allerdings lässt sich das Ansprechen mittels PET-Untersuchung in der Subpopulation mit metastasiertem Plattenepithelkarzinom des Ösophaguskarzinom mit relativ hoher Genauigkeit vorhersagen. Die Früh-Response-Evaluation mittels FDG-PET beim metastasierten Plattenepithelkarzinom des Ösophagus erscheint vielversprechend und sollte in dieser Indikation an größeren Patientenkollektiven untersucht werden.

Keywords

Gastric cancer - oesophageal cancer - positron emission tomography - response

Schlüsselwörter

Magenkarzinom - Ösophaguskarzinom - Positronenemissionstomographie - Response-Evaluation
 

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