Prognostic value of FDG PET-CT metabolic parameters before treatment in patients with esophageal cancer receiving radiotherapy

Abstract

Objective To investigate the prognostic value of metabolic parameters, maximum standard uptake value (SUVmax), metabolic tumour volume (MTV), total lesion glycolysis (TLG), and PET tumor length(PTL), in primary lesions of esophageal cancer on FDG PET-CT imaging in patients receiving radiotherapy or combined radiotherapy. Methods A total of 55 patients with stage Ⅰ-IV esophageal cancer who received PET-CT radiotherapy localization in our hospital from 2006 to 2012 were enrolled. The association of sex, age, primary lesion, TNM stage, SUVmax, MTV, TLG, PTL, and therapeutic methods with the patient's prognosis was analyzed. The receiver operating characteristic curve was used to determine the cut-off values of SUVmax, MTV, TLG, and PTL, and the patients were divided into higher-value group and lower-value group. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis. Results The median overall survival (OS) time for all patients was 19.1 months (95% CI 8.1-30.1), and the 1-, 2-, 3-, and 4-year OS rates were 59%, 45%, 35%, and 26%, respectively. The group with lower values of SUVmax(<11.4), MTV (<8.27 cm3), TLG (<35.21), and PTL (<5.8 cm) had better prognosis than those with higher values (P=0.002, 0.021, 0.044, and 0.000). Conclusions SUVmax, MTV, TLG, and PTL before treatment have certain values in predicting the prognosis of patients with esophageal cancer. Risk stratification can be performed for these patients before radiotherapy according to these parameters, in order to develop individualized treatment regimens and improve prognosis. Key words: Tomography, positron-emission; Fluorodeoxyglucose; Tomography, X-ray computed; Esophageal neoplasms/radiotherapy; Prognosis