Follow up results of a prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer. (February 2017)

• Record Type: Journal Article
• Authors: Ng, Sweet Ping; Tan, Jennifer; Osbourne, Glen; Williams, Luke; Bressel, Mathias A.B.; Hicks, Rodney J.; Lau, Eddie W.F.; Chu, Julie; Ngan, Samuel Y.K.; Leong, Trevor
• Is Part Of: Clinical and translational radiation oncology. Volume 2(2017)
• Page Start: 76
• Page End: 82
• Publication Date: 2017-02
• Subjects: Oesophageal cancer -- PET -- Radiotherapy -- Planning; Cancer -- Radiotherapy -- Periodicals; Oncology -- Periodicals; Cancer -- Radiotherapy; Oncology; Radiation Oncology; Neoplasms -- radiotherapy; Translational Medical Research; Periodicals; Electronic journals; Periodicals; 616.9940642
• DOI: 10.1016/j.ctro.2017.01.008
• Languages: English
• ISSNs: 2405-6308

Abstract

Abstract: Background: This prospective study aims to determine the impact of PET/CT on radiotherapy planning and outcomes in patients with oesophageal cancer. Methods: All patients underwent PET/CT scanning in the radiotherapy treatment position, and received treatment planned using the PET/CT dataset. GTV was defined separately on PET/CT (GTV-PET) and CT (GTV-CT) datasets. A corresponding PTV was generated for each patient. Volumetric and spatial analysis quantified the proportion of FDG-avid disease not included in CT-based volumes. Clinical data was collected to determine locoregional control and overall survival rates. Results: 13 (24.1%) of 57 accrued patients had metastatic disease detected on PET. Median follow up was 4 years. FDG-avid disease would have been excluded from GTV-CT in 29 of 38 patients (76%). In 5 patients, FDG-avid disease would have been completely excluded from the PTV-CT. GTV-CT underestimated the cranial and caudal extent of FDG-avid tumour in 14 (36%) and 10 (26%) patients. 4-Year overall survival and locoregional failure free survival were 37% and 65%. Conclusions: PET/CT altered the delineation of tumour volumes when compared to CT alone, and should be considered standard for treatment planning. Although clinical outcomes were not improved with PET/CT planning, it did allow the use of smaller radiotherapy volumes.