Monitoring of response to pre-operative chemoradiation in combination with hyperthermia in oesophageal cancer by FDG-PET

Figures & data

Table I.  Patient characteristics of responders and non-responders, changes in tumour FDG uptake and histopathologic tumour response.

No.	Sex	AC/SCC	Clinical staging (pre-ThCR)	Pathological staging (post-ThCR)	PA response	SUVBSA-glu at baseline	SUVBSA-glu after 2 weeks of ThCR	Change in SUV (%)
Responders
1	M	SCC	T3N1	T0N0	Complete	0.38	–	–
2	F	SCC	T3N0	T0N0	Complete	0.23	0.11	−50
3	M	SCC	T2N1	T0N0	Complete	0.17	0.06	−63
4	M	AC	T3N0	T0N0	Complete	0.23	0.16	−32
5	M	SCC	T3N1	T0N0	Complete	0.40	0.10	−75
6	M	AC	T1N1	T2N1	Subtotal	ND	–	–
7	M	SCC	T3N0	T2N0	Subtotal	0.21	0.14	−30
8	M	AC	T3N1	T3N1	Subtotal	0.50	0.15	−71
9	M	AC	T3N1	T2N0	Subtotal	0.17	0.11	−31
10	M	AC	T3N0	T3N1	Subtotal	0.10	0.11	2
Non-responders
11	M	AC	T3N1	T3N1	Partial	ND	–	–
12	M	AC	T3N1	T1N0	Partial	0.23	–	–
13	M	AC	T3N1	T3N1	Partial	0.11	0.11	3
14	M	AC	T3N1	T1N1	Partial	0.15	0.11	−31
15	M	AC	T3N1	T3N0	Partial	0.22	0.19	−13
16	M	AC	T3N0	T2N0	Partial	0.16	0.15	−2
17	M	AC	T2N0	T1N0	Minimal	ND	–	–
18	M	AC	T3N0	T3N1	Minimal	ND	–	–
19	M	AC	T2N0	T1N0	Minimal	0.32	–	–
20	M	AC	T3N1	T3N0	Minimal	0.13	0.10	−24
21	M	AC	T3N1	T3N1	Minimal	0.32	0.44	40
22	F	SCC	T3N1	T2N1	Minimal	0.46	0.26	−44
23	M	AC	T3N0	T3N1	Minimal	0.22	0.12	−46
24	M	AC	T3N1	T3N1	No change	ND	–	–
25	M	AC	T4N1		NA	0.33	–	–
26	M	AC	T3N1		NA	0.10	0.11	11

No., patient number; AC, adenocarcinoma; SCC, squamous cell carcinoma; ThCR, thermochemoradiation; F, female; M, male; NA, not applicable; SUV_BSA-glu, standardized uptake value; ND, non-detection.

Figure 1. Individual standardized uptake value (SUV) data of responders and non-responders, before and after 2 weeks of initiation of the neoadjuvant thermochemoradiation therapy (ThCR).

Figure 2. Examples of fluorodeoxyglucose (FDG) positron emission tomography studies (coronal and axial slices) before and 2 weeks after thermochemoradiation therapy, in (a) histopathologically responding and (b) non-responding tumours.

Table II.  Patient characteristics, changes in standardized uptake value (SUV).

	Responders	Non-responders	p-value*
Number of patients	8	8	NS
Age (range)	3 (50–73)	7 (29–73)	NS
Male/Female	7:1	7:1	NS
Histology (AC:SCC)	4:4	7:1	NS
SUV at baseline	0.25 (0.10–0.50)	0.22 (0.11–0.46)	NS
SUV after 2 weeks ThCR	0.11 (0.06–0.16)	0.18 (0.10–0.44)	NS
Median decrease SUV	−44% (−75 to 2%)	−15 (−46 to 40)	0.05

AC, adenocarcinoma; SCC, squamous cell carcinoma; SUV, standardized uptake value; ThCR, thermochemoradiation; NS, not significant.

*Mann–Whitney test.

Figure 3. Receiver operating characteristic curve for assessment of histopathologic response by fluorodeoxyglucose (FDG) positron emission tomography. Changes in FDG uptake from the baseline scan to the scan after 14 days of thermochemoradiation therapy.

Figure 4. Average temperature vs. SUV decrease. Each dot represents the mean SUV decrease in four patients with ascending SUV decrease values.