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FDG-PET might not contribute to improving survival in patients with locally advanced inoperable esophageal cancer

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Abstract

Background

In Japan, positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) has been covered by the national health insurance for esophageal cancer since 2006. FDG-PET is commonly performed in advanced esophageal cancer. The aim of this study was to determine the effect of FDG-PET on survival in patients with locally advanced inoperable esophageal cancer.

Methods

We retrospectively reviewed all patients with cT4 and without M1 esophageal cancer on CT in our institution between 2000 and 2014, and data for 78 patients who meet the eligibility criteria described below were used for analysis in this study. The eligibility criteria included (1) cT4 esophageal cancer without distant metastases or M1 lymph node metastasis (UICC 2002), (2) histologically proven squamous cell carcinoma, (3) 20–79 years of age, (4) having undergone at least 1 cycle of concomitant chemotherapy, (5) having been irradiated with 50 Gy or more, and (6) no other active malignant tumor during treatment.

Results

Two patients were excluded because abdominal lymph node metastases or neck lymph node metastases were detected by FDG-PET. In 78 eligible patients, FDG-PET was not performed before treatment in 41 of the 78 patients and was performed in the other patients. The median observation period was 68 months. The 3-year and 5-year overall survival rates in 78 patients were 36.9% and 30.8%, respectively. There was no significant difference in overall survival or progression-free survival between patients in whom FDG-PET was performed and those in whom FDG-PET was not performed (12.0 months vs. 11.0 months, p = 0.920 and 6.0 months vs. 6.0 months, p = 0.844, respectively).

Conclusions

Compared with only CT, additional information from FDG-PET is not associated with improving survival in patients with locally advanced esophageal cancer. Our results suggest that FDG-PET might not have much meaning for survival in locally advanced esophageal cancer.

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Abbreviations

FDG-PET:

Positron emission tomography using 18F-fluorodeoxyglucose

GTV:

Gross tumor volume

CTV-p:

Clinical target volume for the primary lesion

PTV:

Planning target volume

CDDP:

Cisplatin

5-FU:

5-Fluorouracil

DOC:

Docetaxel

CDGP:

Nedaplatin

OS:

Overall survival

PFS:

Progression-free survival

CI:

Confidence interval

\({\text{SU}}{{\text{V}}_{{\text{max}}}}\) :

Maximum standardized uptake value

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Acknowledgements

This paper was presented at the 12th Congress of the World Federation of Nuclear Medicine and Biology to be held during 20–24th April 2018 in Melbourne.

Funding

Not applicable.

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Authors and Affiliations

  1. Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1–1 Seiryo-chou, Aoba-ku, Sendai, 980–8574, Japan

    Keiichi Jingu, Rei Umezawa, Takaya Yamamoto, Kazuya Takeda, Yojiro Ishikawa, Noriyoshi Takahashi, Noriyuki Kadoya & Haruo Matsushita

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  1. Keiichi Jingu
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  2. Rei Umezawa
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  3. Takaya Yamamoto
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  4. Kazuya Takeda
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  5. Yojiro Ishikawa
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  6. Noriyoshi Takahashi
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  7. Noriyuki Kadoya
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  8. Haruo Matsushita
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Contributions

KJ, HM and KT participated in the design of the study, performed treatment, collected the data and drafted the manuscript; RU, TY, YI and NT and KT participated in the design of the study, performed treatment, and collected the data; and NK participated in the design of the study and performed treatment.

Corresponding author

Correspondence to Keiichi Jingu.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The present study protocol was reviewed and approved by Ethics Committee of Tohoku University Graduate School of Medicine (2014-1-541), and written informed consent for definitive chemoradiotherapy was obtained from each patient before conducting the treatment.

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All data generated or analyzed during this study are included in this published article.

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Jingu, K., Umezawa, R., Yamamoto, T. et al. FDG-PET might not contribute to improving survival in patients with locally advanced inoperable esophageal cancer. Int J Clin Oncol 24, 927–933 (2019). https://doi.org/10.1007/s10147-019-01428-8

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  • DOI: https://doi.org/10.1007/s10147-019-01428-8

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