Evaluated the relationship between the prognostic value of PET/CT and response after concurrent chemoradiotherapy in patients with inoperable stage III esophageal cancer

Abstract

Purpose : This study evaluated the relationship between the prognostic value of PET/CT and response after concurrent chemoradiotherapy (CCRT) in patients with inoperable stage III esophageal cancer.
Methods: We analyzed retrospective and prospective descriptive study of 48 patients with stage III squamous esophageal cancer (T1,2N2M0 hoặc T3,N1,2,M0) who underwent PET/CT scan to calculate values (SUVmax,MTV,TLG) of the esophageal tumor lesion, then received CCRT at K hospital from January 2023 to June 2024. Longitudinal monitoring of treatment and post-treatment to evaluated the relationship between PET/CT values and prognosis based on disease-free survival (PFS) and overall survival (OS).
Results: Research group was 100% male, average age 61,25 6,67. History of smoking and alcohol abuse 81.25%. The most common location tumor is the middle third (45.8%), two segments of the esophagus (22.9%), and rarely the upper third (10.4%). Pre-treatment period T1,2N2 (43.8%) and T3,N1,2 (56.3%). ROC curve analysis for PET/CT parameters related to cT3 stage corresponding SUVmax > 18.5 g/mL (sensitivity(se): 51.9%, specificity(sp): 76.2%, p < 0.01) , TLG > 181.5 g (se: 70 %, sp: 95.6%, p < 0.001), MTV > 25.5 cm3 (se: 66.7%, sp: 99 %, p < 0.001).

Patients received CCRT with radiotherapy dose 50.4 (83.3%), chemical regimens: FOLFOX (56.3%), XELOX (35.4%) and CF (8%). The average follow-up time of the study group was 9.6 months (range 3.02-18.2). After treatment, 36 patients (75%) had disease progression. The significant difference in disease-free survival (PFS) after 12 months of the cT1,2 and cT3 groups was 33.4% and 22.2%, respectively (p<0.05). SUVmax < 18.5 g/mL, MTV < 25.5 cm3 and TLG <181.5 g had a good prognosis with PFS (p<0.05, p<0.001 and p<0.01, respectively). However, there was no significant difference in the SUVmax, MTV, TLG with the OS of the research group.
Conclusion: T stage and esophageal tumor parameters on PET/ CT are meaningful in predicting prognosis and assessing response after concurrent CCRT in patients with inoperable stage III esophageal cancer.