gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

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Prediction of response to chemotherapy using 18-fluorodeoxyglucose positron emission tomography in advanced oesophageal and gastric cancer

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  • corresponding author presenting/speaker Sylvie Lorenzen - 3rd Department of Internal Medicine (Haematology/Medical Oncology), Klinikum rechts der Isar, Technical University of Munich, München, Deutschland
  • Ken Herrmann - Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich
  • Hinrich Wieder - Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich
  • Michael Hennig - Institute for Medical Statistics and Epidemiology, Technical University of Munich
  • Rainer Bredenkamp - Munich Center for Clinical Studies, Klinikum rechts der Isar
  • Christian Peschel - 3rd Department of Internal Medicine (Haematology/Medical Oncology), Klinikum rechts der Isar, Technical University of Munich
  • Michael Schwaiger - Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich
  • Florian Lordick - 3rd Department of Internal Medicine (Haematology/Medical Oncology), Klinikum rechts der Isar, Technical University of Munich

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO202

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dkk2006/06dkk312.shtml

Published: March 20, 2006

© 2006 Lorenzen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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This study was carried through to assess the value of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) for the early metabolic response assessment in oesophago-gastric cancer. 26 patients who were treated for advanced disease (18 adenocarcinomas, 6 squamous-cell cancers) underwent FDG-PET before and two weeks after the onset of chemotherapy with either oxaliplatin-fluorouracil-folinic acid or with docetaxel-capecitabine. 24 tumours (92%) could be visualised by FDG-PET and were also assessable by a second PET 2 weeks after the start of chemotherapy. Receiver Operating Characteristic (ROC) analysis revealed a 30% decrease of the standard uptake value (SUV) as most accurate and clinically meaningful in predicting response according to RECIST. Applying this 30% cut off value, PET imaging correctly predicted clinical response with a sensitivity of 73% and a specificity of 50% (60% and 33% in gastric cancer compared to 100% and 60% in oesophageal cancer). Median time to progression and overall survival were not significantly different for metabolic responders and nonresponders (6.3 versus 5.3 months and 14.1 versus 12.5 months, respectively). Data indicate that FDG-PET is inaccurate for the prediction of response in gastric cancer. In contrast, the method is promising in advanced oesophageal cancer and merits further investigation.