TY - JOUR
T1 - Early metabolic response evaluation by fluorine-18 fluorodeoxyglucose positron emission tomography allows in vivo testing of chemosensitivity in gastric cancer
T2 - Long-term results of a prospective study
AU - Ott, Katja
AU - Herrmann, Ken
AU - Lordick, Florian
AU - Wieder, Hinrich
AU - Weber, Wolfgang A.
AU - Becker, Karen
AU - Buck, Andreas K.
AU - Dobritz, Martin
AU - Fink, Ulrich
AU - Ulm, Kurt
AU - Schuster, Tibor
AU - Schwaiger, Markus
AU - Siewert, Jörg Rüdiger
AU - Krause, Bernd J.
PY - 2008/4/1
Y1 - 2008/4/1
N2 - Purpose: We prospectively evaluated the predictive value of positron emission tomography using fluorine-18 fluorodeoxyglucose (FDG-PET) for in vivo testing of chemosensitivity in locally advanced gastric cancer using an a priori definition of metabolic response (a decrease of >35% of the standard up take value). The goal of the study was the definition of biologically different groups of patients prior too rearly during induction therapy, with special emphasis on FDG non-avid tumors. Experimental Design: Based on our data, which was published in 2003, at least 36 patients with metabolic response or FDG non-avid tumors had to be recruited for an analysis of the group of FDG non-avid tumors with sufficient statistical power. Seventy-one patients (32 metabolic nonresponders, 17 metabolic responders, and 22 patients with FDG non-avid tumors) under-went FDG-PET at baseline. In FDG-avid tumors, FDG-PET was repeated 14 days after the initiation of chemotherapy. Results: Metabolic responders (17 of 49) showed a high histopathologic response rate (69%) and a favorable prognosis (median survival not reached), whereas metabolic nonresponders (32 of 49) had a poor prognosis (median survival, 24.1 months) and showed a histopathologic response in 17%. The histopathologic response rate (24%) for FDG-PET non-avid patients showed no significant difference compared with FDG-avid nonresponders (P = 0.72). Survival of FDG non-avid patients was 36.7 months (not significantly different from FDG-avid nonresponders, 24.1 months, P = 0.46). Conclusion: Inlocally advanced gastric cancer, three different metabolic groups exist. Response and survival was predicted by PET in FDG-avid tumors. Metabolic response assessment was not possible in FDG non - avid tumors; however, due to unfavorable outcome, therapy modification might also be considered in FDG non-avid tumors.
AB - Purpose: We prospectively evaluated the predictive value of positron emission tomography using fluorine-18 fluorodeoxyglucose (FDG-PET) for in vivo testing of chemosensitivity in locally advanced gastric cancer using an a priori definition of metabolic response (a decrease of >35% of the standard up take value). The goal of the study was the definition of biologically different groups of patients prior too rearly during induction therapy, with special emphasis on FDG non-avid tumors. Experimental Design: Based on our data, which was published in 2003, at least 36 patients with metabolic response or FDG non-avid tumors had to be recruited for an analysis of the group of FDG non-avid tumors with sufficient statistical power. Seventy-one patients (32 metabolic nonresponders, 17 metabolic responders, and 22 patients with FDG non-avid tumors) under-went FDG-PET at baseline. In FDG-avid tumors, FDG-PET was repeated 14 days after the initiation of chemotherapy. Results: Metabolic responders (17 of 49) showed a high histopathologic response rate (69%) and a favorable prognosis (median survival not reached), whereas metabolic nonresponders (32 of 49) had a poor prognosis (median survival, 24.1 months) and showed a histopathologic response in 17%. The histopathologic response rate (24%) for FDG-PET non-avid patients showed no significant difference compared with FDG-avid nonresponders (P = 0.72). Survival of FDG non-avid patients was 36.7 months (not significantly different from FDG-avid nonresponders, 24.1 months, P = 0.46). Conclusion: Inlocally advanced gastric cancer, three different metabolic groups exist. Response and survival was predicted by PET in FDG-avid tumors. Metabolic response assessment was not possible in FDG non - avid tumors; however, due to unfavorable outcome, therapy modification might also be considered in FDG non-avid tumors.
UR - http://www.scopus.com/inward/record.url?scp=42249090022&partnerID=8YFLogxK
U2 - 10.1158/1078-0432.CCR-07-0934
DO - 10.1158/1078-0432.CCR-07-0934
M3 - Article
C2 - 18381939
AN - SCOPUS:42249090022
SN - 1078-0432
VL - 14
SP - 2012
EP - 2018
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 7
ER -
