Prediction of outcome with FDG-PET in definitive chemoradiotherapy for esophageal cancer

The purpose of this study was to assess the efficacy of 18f-fluoro-2-deoxy-glucose uptake positron emission tomography (fdg-pet) for the prediction of outcome in definitive chemoradiotherapy (crt) for esophageal cancer. we enrolled 56 patients with esophageal cancer treated with definitive crt and examined by fdg-pet before treatment. we examined the correlation of the maximum standardized uptake value (suvmax) in fdg-pet of the primary tumor with overall survival (os),progression-free survival (pfs),local control (lc) and response of the primary tumor. after definitive crt,30 patients had a clinical complete response (cr),making the cr rate 54%. for all 56 patients,the 2-year os rate,pfs rate and lc rates were 64%,38% and 51%,respectively. we divided the patients into two groups according to suvmax: suvmax < 10 (low-suv) and <10 (high-suv). the 2-year os rates in the low- and high-suv groups were 100% and 41%,the pfs rates were 73% and 19%,the lc rates were 71% and 39%,and the cr rates were 100% and 32%,respectively. a univariate analysis revealed significant differences between the low- and high-suv group in os,pfs,lc and response (p = 0.0005,0.0002,0.048,and <0.0001,respectively). suvmax and t stage were significantly associated with os,pfs,lc and response. a multivariate analysis showed significant differences between the suvmax <10 and ≥10 groups in overall survival and response (p < 0.05). our result suggests that the suvmax in fdg-pet of the primary tumor before treatment may have prognostic value for esophageal cancer. © the author 2013. published by oxford university press on behalf of the japan radiation research society and japanese society for therapeutic radiology and oncology.