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PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study

التفاصيل البيبلوغرافية
العنوان: PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study
المؤلفون: Radka Obermannova, Iveta Selingerova, Zdenek Rehak, Vaclav Jedlicka, Marek Slavik, Pavel Fabian, Ivo Novotny, Milada Zemanova, Hana Studentova, Peter Grell, Lenka Zdrazilova Dubska, Regina Demlova, Tomas Harustiak, Renata Hejnova, Igor Kiss, Rostislav Vyzula
المصدر: Therapeutic Advances in Medical Oncology, Vol 13 (2021)
بيانات النشر: SAGE Publishing, 2021.
سنة النشر: 2021
المجموعة: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
مصطلحات موضوعية: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: Background: Perioperative chemotherapy is a recommended treatment approach for localised oesophago-gastric junction adenocarcinoma, but not all patients respond to neoadjuvant chemotherapy. Early identification of non-responders and treatment adaptation in the preoperative period could improve outcomes. GastroPET is a national, multicentre phase II trial evaluating a 18 FDG-PET/CT-guided preoperative treatment strategy with the R0 resection rate as a primary endpoint. Here, we report on the accuracy of the methodology, the feasibility of the study design and patient safety data after enrolment of the first 63 patients. Methods: Patients with locally advanced oesophago-gastric junction adenocarcinoma (Siewert I – III) stage Ib–IIIc underwent baseline 18FDG-PET/CT scanning and re-evaluation after 14 days of oxaliplatinum-5FU-(docetaxel) chemotherapy. Responders were defined by a ⩾ 35% decrease in tumour FDG standardised uptake value (SUV) average from baseline. Responders continued with the same chemotherapy for 2 to 3 months prior to surgery. PET-non-responders switched to preoperative chemoradiotherapy [weekly carboplatin and paclitaxel with concurrent radiotherapy (45 Gy in 25 fractions)]. Here, we aim to confirm the feasibility of FDG-PET-based response assessment in a multicenter setting and to compare local versus central reading. In addition, we report on the feasibility of the study conduct and patient safety data. Results: A total of 64 patients received baseline and sequential 14-day 18FDG-PET/CT scanning. And, 63 were allocated to the respective treatment arm according to PET-response [35 (56%) responders and 28 (44%) non-responders]. The concordance of local versus central reading of SUV changes was 100%. Until the date of this analysis, 47 patients (28 responders and 19 non-responders) completed surgery. Postoperative complications of grade ⩾ 3 (Common Terminology Criteria for Adverse Events, CTCAE Version 5.0) were reported in five responders (18%; 95% CI: 7.9–36%) and two non-responders (11%; 95% CI: 2.9–31%), with no statistical difference ( p = 0.685). One patient in each arm died after surgery, leading to a postoperative in-hospital mortality rate of 4.3% (2/47 patients; 95% CI: 1.2–14%). Conclusion: Local and central FDG-SUV quantification and PET-response assessment showed high concordance. This confirms the accuracy of a PET-response-guided treatment algorithm for locally advanced oesophago-gastric junction cancer in a multicenter setting. Preoperative treatment adaptation revealed feasible and safe for patients.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1758-8359
17588359
Relation: https://doaj.org/toc/1758-8359
DOI: 10.1177/17588359211065153
URL الوصول: https://doaj.org/article/fdb8af992495421d81803942b0afe118
رقم الأكسشن: edsdoj.fdb8af992495421d81803942b0afe118
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:17588359
DOI:10.1177/17588359211065153