Yazarlar : Zhu W, Xing L, Yue J, Sun X, Sun X, Zhao H, Yu J.

Yayın : Br J Radiol.

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22337686

Konu : Radyasyon Onkolojisi

Literatür İçeriği :  

Abstract

Objective: To comprehensively review the evidence for use of pre-treatment, post-treatment and changes in tumour glucose uptake that were assessed by (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) early, during, or immediately after neoadjuvant chemotherapy/chemoradiation to predict prognosis of localised oesophagogastric junction (AEG) cancer.Methods: We searched for articles published in English; limited to AEG; (18)F-FDG uptake on PET performed on a dedicated device; dealt with the impact of standardised uptake value (SUV) on survival. We extracted an estimate of the log hazard ratios (HRs) and their variances and performed meta-analysis.Results: 798 patients with AEG were included. And the scan time for FDG-PET was as follows: prior to therapy (PET1, n = 646), exactly 2 weeks after initiation of neoadjuvant therapy (PET2, n = 245), and pre-operatively (PET3, n = 278). In the two meta-analyses for overall survival including the studies dealt with reduction of tumour maximum SUV (SUV(max)) (from PET1 to PET2/PET3 and from PET1 to PET2), the results were similar, with the overall HR for non-responders being 1.83 [95% confidence interval (CI), 1.41, 2.36] and 2.62 (95% CI, 1.61, 4.26), respectively. As for disease-free survival, the combined HR was 2.92 (95% CI, 2.08, 4.10) and 2.39 (95% CI, 1.57, 3.64), respectively. The meta-analyses did not attribute significant prognostic values to SUV(max) before and during therapy in localised AEG.Conclusion: Relative changes in FDG-uptake of AEG are better prognosticators. Early metabolic changes from PET1 to PET2 may provide the same accuracy for prediction of treatment outcome as late changes from PET1 to PET3

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