PS02.066: ROLE OF 18F-FDG-PET/CT IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER NEOADJUVANT CHEMORADIOTHERAPY

Abstract

Abstract Background The aim of this study was to assess the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) in predicting pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT). Methods Thirty patients with advanced ESCC received nCRT followed by surgery, and underwent FDG-PET/CT twice before and after nCRT. We compared the results of FDG-PET/CT with the pathological results and prognosis. Results Pathological response was found to correlate with the maximum standardised uptake value (SUVmax) after nCRT and the rate of decrease of SUVmax. Using univariate analysis, pN, SUVmax after nCRT and the rate of decrease of SUVmax were found to be prognostic factors. Multivariate analysis revealed that only pN was an independent prognostic factor Conclusion The prediction of pathological response and prognosis using FDG-PET/CT is not as reliable as pathological detection of lymph node metastasis, but could be a useful method contributing to treatment decisions. Neoadjuvant chemoradiotherapy (nCRT) plus surgery has been shown to improve survival rates and should be regarded as a standard of care for patients with locally advanced esophageal squamous cell carcinoma (ESCC). Appropriate evaluation of nCRT efficacy based on noninvasive parameters might help in individualizing treatments for patients with ESCC. 18F-fluorodeoxyglucose positronemission tomography/computed tomography (FDG-PET/CT) reflects tumor cell viability based on enhanced FDG uptake as a result of increased glucose metabolism. FDG-PET/CT is useful for the staging of advanced ESCC before treatment, and for evaluating the response to nCRT; however, findings from currently available studies in this regard are controversial. In the present study, we examined the role and usefulness of FDG-PET/CT in decisions regarding staging, prediction of histopathological response, and overall survival in patients with advanced ESCC treated with nCRT; this was achieved by analyzing the maximum standardized uptake value (SUVmax) before and after treatment, and the rate of decrease of SUVmax. Disclosure All authors have declared no conflicts of interest.