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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Baseline 18F-FDG PET/CT quantitative parameters as prognostic factors in esophag...
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Vol. 41. Issue 3.
Pages 164-170 (May - June 2022)
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Vol. 41. Issue 3.
Pages 164-170 (May - June 2022)
Original Article
Baseline 18F-FDG PET/CT quantitative parameters as prognostic factors in esophageal squamous cell cancer
Parámetros cuantitativos de la PET/TC basal con 18F-FDG como factores pronósticos en el carcinoma de células escamosas de esófago
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A. Martíneza,
Corresponding author
, J.R. Infantea, J. Quirósb, J.I. Rayoa, J. Serranoa, M. Morenoa, P. Jiméneza, A. Coboa, A. Baenaa
a Servicio de Medicina Nuclear, Hospital Universitario de Badajoz, Badajoz, Spain
b Servicio de Oncología Radioterápica, Hospital Universitario de Badajoz, Badajoz, Spain
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Tables (5)
Table 1. Eighth edition of the AJCC-TNM classification.
Table 2. Characteristics of the patients, tumoral lesions and treatments administered.
Table 3. Metabolic parameters.
Table 4. Comparison of different parameters between responder and non responder patients.
Table 5. Cut-off point in receiver operating characteristic curves and their significance.
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Abstract
Aim

To determine the utility of [18F]FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal squamous cell carcinoma (SCC).

Material and methods

Thirty patients (29 men) diagnosed with SCC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from baseline PET/CT study. After treatment with chemotherapy and/or radiotherapy, response to treatment and patient survival were assessed. The comparison of parameters between groups of responders and non-responders was carried out using a Mann-Whitney U test ROC curves and the Kaplan-Meier method were used for analysis of prognostic factors and survival curves.

Results

The average follow-up was 22.4 months, with 22 recurrence-progressions and 25 deaths. Significant differences were demonstrated between responders and non-responders with respect to tumor size, MTV and TLG. Survival analysis found significant differences for SCE and CSS depending on these three parameters.

Conclusion

Metabolic parameters MTV and TLG, and tumor size were prognostic factors for neoadjuvant treatment response, PFS, and CSS in patients diagnosed with SCC. Neither SUVmax nor SUVmed were predictive for any of the evaluation criteria. Results could help to personalize patient treatment.

Keywords:
PET/CT
Esophageal cancer
Squamous cell cancer
SUV
MTV
TLG
Resumen
Objetivo

Determinar la utilidad de los parámetros cuantitativos de la PET/TC con [18F]FDG como factores pronósticos para la respuesta al tratamiento neoadyuvante, la supervivencia libre de progresión (SLP) y la supervivencia cáncer específica (SCE) en pacientes con carcinoma de células escamosas de esófago (CCE).

Material y métodos

Se valoraron retrospectivamente 30 pacientes (29 hombres) diagnosticados de CCE durante un intervalo de 6 años. Se determinaron los parámetros metabólicos SUV máximo (SUVmax), SUV medio (SUVmed), volumen metabólico tumoral (MTV) y glicolisis tumoral total (TLG) del estudio PET/TC al diagnóstico. Tras tratamiento con quimioterapia y/o radioterapia, se valoró la respuesta al tratamiento y la supervivencia de los pacientes. La comparación de parámetros entre grupos de respondedores y no respondedores se realizó mediante la prueba U de Mann-Whitney. Las curvas ROC y el método de Kaplan-Meier se utilizaron para el análisis de factores pronósticos y curvas de supervivencia.

Resultados

El seguimiento medio fue de 22,4 meses, produciéndose 22 recurrencias-progresiones y 25 exitus. Se demostraron diferencias significativas entre respondedores y no respondedores con respecto al tamaño tumoral, el MTV y la TLG. El análisis de supervivencia halló diferencias significativas para SCE y SLP dependiendo de estos tres parámetros.

Conclusión

Los parámetros metabólicos MTV y TLG, así como el tamaño tumoral, fueron factores pronósticos para la respuesta al tratamiento neoadyuvante, la SLP y la SCE en pacientes diagnosticados de CCE. Ni el SUVmax ni el SUVmed fueron predictores para ninguno de los criterios de evaluación. Los resultados permitirían personalizar el tratamiento de los pacientes.

Palabras clave:
PET/TC
Cáncer de esófago
Carcinoma de células escamosas
SUV
MTV
TLG

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