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Gan to kagaku ryoho. Cancer & chemotherapy

[Utility and drawbacks of fludeoxyglucose-positron emission tomography in locally advanced esophageal cancer treated by neoadjuvant chemotherapy followed by esophagectomy].


PMID 24394040

Abstract

In Japan, neoadjuvant chemotherapy followed by esophagectomy has become the standard treatment for resectable advanced esophageal cancer. However, there are few reports on the utility of fludeoxyglucose( FDG)-positron emission tomography (PET) in such cases so far. In this study, we analyzed the utility and drawbacks of FDG-PET in patients who underwent neoadjuvant chemotherapy followed by surgery. Thirty-seven patients with cStage II or III thoracic esophageal cancer who received 2 courses of combination chemotherapy with 5-fluorouracil and cisplatin followed by surgery were enrolled this study. The maximum standardized uptake value (SUVmax) in the main lesion significantly decreased after chemotherapy (38.6%), and there was a greater decrease in SUVmax in patients with downstaging. Following chemotherapy, the esophageal lesions were not detected by FDG-PET in 6 patients. However, in these patients, the histopathological diagnosis of the resected specimens revealed that the cancer cells persisted. The SUVmax increased after chemotherapy in 5 patients, and in 4 of 5 patients recurrent disease was observed. In conclusion, we should understand the characteristics of FDG-PET in esophageal cancer after neoadjuvant chemotherapy and use it precisely.

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