Interim 18F-FDG-PET/CT during chemo-radiotherapy in the management of oesophageal cancer patients. A systematic review

Radiother Oncol. 2017 Nov;125(2):200-212. doi: 10.1016/j.radonc.2017.09.022. Epub 2017 Oct 10.

Abstract

Oesophageal cancer is an aggressive disease. The possibility to early stratify patients as responsive and non-responsive with a non-invasive method is extremely appealing. The uptake of Fluorodeoxyglucose (18F-FDG) in tumours, provided by positron emission tomography (PET) images, has been proved to be useful to assess the initial staging of the disease, recurrence, and response to chemotherapy and chemo-radiotherapy (CRT). In the last years, efforts have been focused on the possibility to use ad interim 18F-FDG-PET/CT (PETint) to evaluate response during radiation therapy. However, controversial findings have been reported, although some relevant results would support its use for individual therapeutic decision. The present review assembles the comprehensive literature of the last decade to evaluate whether and in which cases PETint may offer predictive potential in oesophageal cancer. All the analysed studies (13 studies, 697 patients) denoted PETint as a challenging examination for early assessment of outcomes during CRT. In particular, 8 studies advocated the predictivity of PETint, whilst 5 did not find any correlation between the interim variation of PET parameters and the pathological complete response and/or the clinical outcome. The reasons that possibly have caused contradictions among the studies demand further research with prospective and uniform protocols and methods of analysis to assess the predictive and prognostic value of PETint in oesophageal cancer.

Trial registration: ClinicalTrials.gov NCT01913717.

Keywords: Ad-interim FDG-PET; Chemo-radiotherapy; Oesophageal cancer; Tumour response.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Chemoradiotherapy
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / radiotherapy
  • Esophageal Neoplasms / therapy*
  • Fluorodeoxyglucose F18*
  • Humans
  • Positron Emission Tomography Computed Tomography / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Radiopharmaceuticals*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18

Associated data

  • ClinicalTrials.gov/NCT01913717