Usefulness of whole body FDG-PET for the prediction of pathologic response after neoadjuvant chemoradiotherapy in locally advanced resectable esophageal cancer

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 4075-4075
Author(s):  
S. Y. Song ◽  
J. H. Kim ◽  
J. S. Ryu ◽  
E. K. Choi ◽  
G. H. Lee ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathologic Response ◽  
Whole Body ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer

scholarly journals Addition of HER2 and CD44 to 18F-FDG PET–based clinico-radiomic models enhances prediction of neoadjuvant chemoradiotherapy response in esophageal cancer

2020 ◽  
Author(s):  
Roelof J. Beukinga ◽  
Da Wang ◽  
Arend Karrenbeld ◽  
Willemieke P. M. Dijksterhuis ◽  
Hette Faber ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Markers ◽  
Fdg Pet ◽  
Prediction Models ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathologic Response ◽  
Tumor Regression Grade ◽  
Biological Tumor Markers ◽  
Complementary Value

Abstract Objectives To assess the complementary value of human epidermal growth factor receptor 2 (HER2)-related biological tumor markers to clinico-radiomic models in predicting complete response to neoadjuvant chemoradiotherapy (NCRT) in esophageal cancer patients. Methods Expression of HER2 was assessed by immunohistochemistry in pre-treatment tumor biopsies of 96 patients with locally advanced esophageal cancer. Five other potentially active HER2-related biological tumor markers in esophageal cancer were examined in a sub-analysis on 43 patients. Patients received at least four of the five cycles of chemotherapy and full radiotherapy regimen followed by esophagectomy. Three reference clinico-radiomic models based on 18F-FDG PET were constructed to predict pathologic response, which was categorized into complete versus incomplete (Mandard tumor regression grade 1 vs. 2–5). The complementary value of the biological tumor markers was evaluated by internal validation through bootstrapping. Results Pathologic examination revealed 21 (22%) complete and 75 (78%) incomplete responders. HER2 and cluster of differentiation 44 (CD44), analyzed in the sub-analysis, were univariably associated with pathologic response. Incorporation of HER2 and CD44 into the reference models improved the overall performance (R2s of 0.221, 0.270, and 0.225) and discrimination AUCs of 0.759, 0.857, and 0.816. All models exhibited moderate to good calibration. The remaining studied biological tumor markers did not yield model improvement. Conclusions Incorporation of HER2 and CD44 into clinico-radiomic prediction models improved NCRT response prediction in esophageal cancer. These biological tumor markers are promising in initial response evaluation. Key Points • A multimodality approach, integrating independent genomic and radiomic information, is promising to improve prediction of γpCR in patients with esophageal cancer. • HER2 and CD44 are potential biological tumor markers in the initial work-up of patients with esophageal cancer. • Prediction models combining 18F-FDG PET radiomic features with HER2 and CD44 may be useful in the decision to omit surgery after neoadjuvant chemoradiotherapy in patients with esophageal cancer.

Interim FDG-PET imaging during neoadjuvant chemoradiotherapy for esophageal cancer: Correlation with pathologic response.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 175-175
Author(s):  
Daniel Tandberg ◽  
Julian C. Hong ◽  
Yunfeng Cui ◽  
Brad Ackerson ◽  
Brian G. Czito ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Fdg Pet ◽  
Tumor Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathologic Response ◽  
Relative Reduction ◽  
Interim Pet ◽  
Significant Difference ◽  
Manual Contour ◽  
Pre Treatment

175 Background: In this prospective study we evaluated whether changes in metabolic tumor parameters on interim flurodeoxyglucose positron emission tomography (FDG-PET) performed during neoadjuvant chemoradiotherapy (CRT) for esophageal cancer correlates with histopathologic tumor response. Methods: From February 2012 to February 2016, 60 patients with esophageal cancer underwent PET scans before therapy and after 30-36 Gy. Patients who underwent surgery after carboplatin/paclitaxel CRT were eligible for the current analysis. PET metrics of the primary site including maximum standardized uptake value (SUVmax), SUV mean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were extracted from the pre-treatment and interim PET based on a manual contour and SUV 2.5 threshold. Patients were called histopathologic responders if they had a complete or near complete tumor response based on the modified Ryan scheme. Relative changes in PET metrics between pre-treatment and interim PET were compared between histopathologic responders and non-responders using the Mann-Whitney test and binary logistic regression. Results: Twenty-six patients were included in the analysis. Adenocarcinoma was the most common histology (n = 23). Eleven patients (42%) had a complete or near complete pathologic response to CRT (histopathologic responders). Changes in PET metrics from pre-treatment to interim PET based on the manual contour were not significantly different between responding and nonresponding tumors. The relative reduction of SUVmax (Mean ± SD) was 38.2% ± 28.4% for histopathologic responders and 27.9% ± 31.4% for non-responders. The relative reduction in MTV, SUV mean and TLG was 36.1% ± 26.2%, 23.5% ± 21.3%, and 49.3% ± 28.3% for histopathologic responders and 28.6% ± 32.0%, 11.8% ± 19.1%, and 33.1% ± 38.5% for histopathologic non-responders, respectively. When analyzed based on the SUV 2.5 threshold there continued to be no significant difference in PET metrics. Conclusions: In this pilot study we observed changes in metabolic tumor parameters on PET performed during CRT for esophageal cancer. However, these changes did not predict for histopathologic responders.

Practice patterns in the treatment of locally advanced resectable esophageal carcinoma: A national survey of Canadian thoracic surgeons.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14695-e14695
Author(s):  
Gordon Buduhan
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Practice Patterns ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiation ◽  
The Other ◽  
Insufficient Evidence ◽  
Canadian Association ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer

e14695 Background: Many institutions have adopted a multimodality strategy for treating locally advanced resectable esophageal cancer including surgery, chemotherapy and radiation. While many neoadjuvant protocols have been studied, there is no well defined standard treatment. In order to determine current practices and clinician opinions regarding treatment of esophageal cancer, a survey study of practicing Canadian thoracic surgeons was performed. Methods: Members of the Canadian Association of Thoracic Surgeons were contacted by email; those who currently treat esophageal cancer were asked to complete an online survey. Three separate emails were sent to maximize participation. Results: The response rate was 54% (56 /104). Of the respondents, 85% exclusively practiced general thoracic surgery, 87% worked at a University-affiliated hospital. We presented a hypothetical patient with bulky, resectable distal esophageal adenocarcinoma with enlarged paraesophageal lymph nodes (T3N1M0). 54% stated that neoadjuvant chemoradiation followed by surgery was their institution’s treatment of choice, while 33% used neoadjuvant chemotherapy plus surgery. When asked to choose the best treatment for this patient based on available evidence, 33% chose neoadjuvant chemoradiation, 33% favored neoadjuvant chemotherapy, 31% were undecided. Regarding neoadjuvant chemotherapy vs. chemoradiation, 63% strongly agreed or agreed there was insufficient evidence to decide whether or not one treatment was superior to the other. 73% strongly agreed or agreed to support a future randomized trial of preoperative chemotherapy vs. preoperative chemoradiation for esophageal cancer patients. Conclusions: Most Canadian thoracic surgeons use either neoadjuvant chemotherapy or chemoradiation followed by surgery for locally advanced resectable esophageal cancer. There is wide variation in practice patterns with no clear standard approach. 63% feel there is insufficient evidence to decide whether or not one treatment is superior to the other, and the majority support a future trial of neoadjuvant chemotherapy vs. chemoradiation. A pilot study is being planned to determine feasibility.

scholarly journals Phase I evaluation of TNFerade biologic plus chemoradiotherapy before esophagectomy for locally advanced resectable esophageal cancer

2012 ◽  
Vol 75 (6) ◽  
pp. 1139-1146.e2 ◽  
Author(s):  
Kenneth J. Chang ◽  
Tony Reid ◽  
Neil Senzer ◽  
Stephen Swisher ◽  
Harlan Pinto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Phase I ◽  
Locally Advanced ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer
Sign in / Sign up

Export Citation Format

Share Document