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Pretreatment 18F-FDG PET/CT-Derived Parameters in Predicting Clinical Outcomes of Locally Advanced Upper Third Esophageal Squamous Cell Carcinoma After Definitive Chemoradiation Therapy

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Abstract

Purpose

The aim of this study was to investigate whether standard uptake values (SUVs) of pretreatment 18F-FDG PET/CT were the surrogate parameters for predicting the outcomes in locally advanced esophageal squamous cell carcinoma patients treated with definitive chemoradiotherapy.

Materials and Methods

Sixty patients with esophageal squamous cell carcinoma underwent pretreatment 18F-FDG PET/CT and received definitive chemoradiotherapy. 18F-FDG metabolic parameters including SUVmax, SUVmean, SULpeak, total lesion glycolysis (TLG), and metabolic tumor volume (MTV) of primary tumor were calculated. The receiver-operating characteristic (ROC) curve was used to determine the optimal cutoff value of FDG PET/CT-derived parameters that associated with treatment response. Estimating progression-free survival (PFS) and overall survival (OS) was analyzed by using Kaplan–Meier methods. Univariate and multivariate analysis for PFS and OS was performed using Cox regression.

Results

Complete response was achieved in 38.3%. The 4-year OS and PFS rates were 48.6% and 44.4%, respectively. SUVmean with a cutoff value of 6.1 could predict complete response with sensitivity of 69.6%, specificity of 78.4%, and accuracy of 75%. Cox multi-factor regression analyses revealed SUVmean > 6.1 as an independent prognostic factor for OS (HR = 6.74, p = 0.02) and PFS (HR = 6.53, p < 0.001).

Conclusions

Our study suggests that SUVmean of the primary tumor in pretreatment 18F-FDG PET/CT may be used as an independent predictor in esophageal squamous cell carcinoma patients treated with definitive chemoradiotherapy.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank all staffs in the Nuclear Medicine, Radiation Oncology & Radiosurgery Department for collecting the data and Ms Le Kieu Minh, Mr Pham Xuan Hung and Mr Glenn Sy for the technical support.

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Authors and Affiliations

  1. Department of Nuclear Medicine, 108 Military Central Hospital, Hanoi, Vietnam

    Le Ngoc Ha & Mai Hong Son

  2. Department of Radiation Oncology and Radiosurgery, 108 Military Central Hospital, Hanoi, Vietnam

    Nguyen Dinh Chau & Bui Quang Bieu

Authors
  1. Le Ngoc Ha
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  2. Nguyen Dinh Chau
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  3. Bui Quang Bieu
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  4. Mai Hong Son
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Contributions

Basic study idea was made by M.H.S; L.N.H and N.D.C conducted patient management and procedures. Data were curated by N.D.C and B.Q.B., analyzed by M.H.S and N.D.C, and validated by L.N.H. Draft of manuscript was written by L.N.H. M.H.S. and N.D.C and reviewed by all authors. M.H.S edited the manuscript.

Corresponding author

Correspondence to Mai Hong Son.

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Competing Interests

Le Ngoc Ha, Nguyen Dinh Chau, Bui Quang Bieu, and Mai Hong Son declare that they have no conflict of interest.

Ethics Approval and Consent to Participate

This study was approved by the institutional review board of Central Military Hospital 108 (approval no. 165/QD-V108).

Consent for Publication

As the procedures involved were standard of care, the committee agreed to waive the need for written informed consent.

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Ha, L.N., Chau, N.D., Bieu, B.Q. et al. Pretreatment 18F-FDG PET/CT-Derived Parameters in Predicting Clinical Outcomes of Locally Advanced Upper Third Esophageal Squamous Cell Carcinoma After Definitive Chemoradiation Therapy. Nucl Med Mol Imaging 56, 181–187 (2022). https://doi.org/10.1007/s13139-022-00751-9

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