Valoración de los parámetros cuantitativos de la PET/TC con [¹⁸F]FDG como factores pronósticos en el cáncer de esófago

Resum

Aim: To determine the utility of [18F]FDG PET/CT quantitative parameters as prognostic factors for the response to neoadjuvant treatment, overall survival (OS), progression-free survival (PFS) and cancer-specific survival (CSS) in patients with esophageal cancer (EC). Material and Methods: One hundred patients (93 men) diagnosed with EC were retrospectively evaluated over a 6-year interval. Metabolic parameters were determined: maximum SUV (SUVmax), mean SUV (SUVmed), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and parameters derived from the lesion/liver ratio 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 21.3 months, with 66 recurrence-progressions and 89 deaths. Significant differences were demonstrated between responders and non-responders with respect to tumor size, stage, MTV and TLG. Survival analysis found significant differences for OS, SCE and CSS depending on these three parameters. Conclusions: Metabolic parameters MTV and TLG, tumor size and stage were prognostic factors for neoadjuvant treatment response, OS, PFS, and CSS in patients diagnosed with EC. None of the other PET parameters were predictive for any of the evaluation criteria. Results could help to personalize patient treatment.