Thématique :
- Cancers autres (hors CCR et CHC)
Originalité :
Solidité :
A confirmer
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
Digestive and Liver Disease
  2019 Jun;51(6):887-893.  
  doi: 10.1016/j.dld.2018.12.006.  
  Early metabolic response to chemoradiotherapy by interim FDG PET/CT is associated with better overall survival and histological response in esophageal cancers  
  Hammoudi N, Hennequin C, Vercellino L, Costantini A, Valverde A, Cattan P, Quéro L  



Early assessment of response to neoadjuvant chemoradiotherapy (CRT) is crucial in determining the most suitable treatment strategy in locally advanced oesophageal cancer (LAEC).


We evaluated the impact of early metabolic response during CRT on overall survival (OS) and histological response.


Patients with biopsy-proven oesophageal carcinoma underwent FDG PET/CT with evaluation of the standardized uptake value (SUV) before any treatment and during CRT after 20 Gy.


116 patients (Male: 66.4%, Median age: 63; squamous cell carcinomas (SCC): 70%) met inclusion criteria. Median OS was 21.7 months. There was a significant positive correlation between interim metabolic response and OS. In multivariate analysis, only metabolic response using the 50% cut-off value remained significantly associated with OS (IC95% = 0.28-0.73; p = 0.001). In this statistical analysis, surgery (p = 0.007) and T stage (p = 0.023) were also correlated with OS. There was a significant correlation between early metabolic response and local recurrence (Chi-squared test p = 0.0001).


Early metabolic response using FDG PET/CT is associated with better OS, disease-free survival, local control and pathological response in patients treated by CRT for LAEC.


Question posée
Intérêt de la réalisation d’un petscan précoce lors de la radio-chimiothérapie pré-opératoire des cancers de l’oesophage.
Question posée
Le petscan réalisé lors de la radiochimiothérapie, après 20Gy est prédictif de la survie, de la survie sans maladie, du contrôle local et de la réponse pathologique.