Role of <sup>18</sup>F‐Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Predicting the Pathologic Response to Preoperative Chemoradiation Therapy in Patients With Resectable T3 Pancreatic Cancer

Kittaka, Hirotada; Takahashi, Hidenori; Ohigashi, Hajime; Gotoh, Kunihito; Yamada, Terumasa; Tomita, Yoshihiro; Hasegawa, Yoshihisa; Yano, Masahiko; Ishikawa, Osamu

doi:10.1007/s00268-012-1775-x

Cited by 71 publications

(43 citation statements)

References 55 publications

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“…Only one study that showed a correlation with FDG-PET parameters with treatment response was found. Higher baseline SUV max was associated with a histopathological response – the predictive function of FDG-PET in this series was increased by combining the baseline SUV max with the relative SUV response after CRT [44]. It should be noted that this series defined histopathological response as <50% viable tumour cells seen in a resection specimen.…”

Section: Resultsmentioning

confidence: 72%

The Application of Functional Imaging Techniques to Personalise Chemoradiotherapy in Upper Gastrointestinal Malignancies

Wilson

Hawkins

2014

Clinical Oncology

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Functional imaging gives information about physiological heterogeneity in tumours. The utility of functional imaging tests in providing predictive and prognostic information after chemoradiotherapy for both oesophageal cancer and pancreatic cancer will be reviewed. The benefit of incorporating functional imaging into radiotherapy planning is also evaluated. In cancers of the upper gastrointestinal tract, the vast majority of functional imaging studies have used 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Few studies in locally advanced pancreatic cancer have investigated the utility of functional imaging in risk-stratifying patients or aiding target volume definition. Certain themes from the oesophageal data emerge, including the need for a multiparametric assessment of functional images and the added value of response assessment rather than relying on single time point measures. The sensitivity and specificity of FDG-PET to predict treatment response and survival are not currently high enough to inform treatment decisions. This suggests that a multimodal, multiparametric approach may be required. FDG-PET improves target volume definition in oesophageal cancer by improving the accuracy of tumour length definition and by improving the nodal staging of patients. The ideal functional imaging test would accurately identify patients who are unlikely to achieve a pathological complete response after chemoradiotherapy and would aid the delineation of a biological target volume that could be used for treatment intensification. The current limitations of published studies prevent integrating imaging-derived parameters into decision making on an individual patient basis. These limitations should inform future trial design in oesophageal and pancreatic cancers.

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Section: Resultsmentioning

confidence: 72%

The Application of Functional Imaging Techniques to Personalise Chemoradiotherapy in Upper Gastrointestinal Malignancies

Wilson

Hawkins

2014

Clinical Oncology

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“…The past literature demonstrated that it can be difficult to evaluate local tumor progression accurately by radiological evaluation after chemotherapy and/or chemoradiation therapy [14]. And the other studies have shown that tumor markers or PET findings are sometimes helpful in estimating the efficacy of anti-cancer therapy [15, 16]. However, in this case, tumor markers were not increased and PET findings were normal before the first-line treatment.…”

Section: Discussionmentioning

confidence: 87%

Locally advanced pancreatic cancer successfully treated by distal pancreatectomy with celiac axis resection (DP-CAR) after S-1 with radiation therapy followed by gemcitabine/nab-paclitaxel therapy: a case report

et al. 2017

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BackgroundThe prognosis for pancreatic cancer remains dismal because many patients are diagnosed with unresectable cancer at the initial diagnosis. Recently, conversion surgery was reported as an effective treatment for initially unresectable pancreatic cancer with a favorable response to non-surgical treatment lasting over 240 days. Here, we describe a case of locally advanced pancreatic cancer (LAPC) successfully resected after treatment with S-1 and radiation followed by gemcitabine/nab-paclitaxel therapy.Case presentationA 73-year-old man with LAPC was referred to our hospital. Computed tomography findings revealed a 2.5-cm mass in the pancreatic body that had invaded the celiac artery, common hepatic artery, and splenic artery. Superior mesenteric artery (SMA) encasement was not observed, but tumor abutment over 180° with the main tumor was detected. Staging laparoscopy showed no findings of distant metastasis, and washing cytology revealed no malignancy. He was diagnosed with unresectable pancreatic cancer. Treatment with S-1 with radiation therapy followed by gemcitabine with nab-paclitaxel was performed. Six months after the initial treatment, the tumor size had decreased to 1.2 cm, and encasement of the main artery was diminished. Though abutment to the main artery, including the SMA, was still detected, distal pancreatectomy with celiac artery resection was performed. The histopathological findings around the celiac artery revealed fibrous changes with an Evans classification of grade IIb. There was no residual cancer at the periphery; thus, R0 resection was achieved. The patient has been healthy and without recurrence for more than 12 months since the initial treatment.ConclusionsGemcitabine/nab-paclitaxel therapy revealed high response rate for metastasic pancreatic cancer (PC), but the effect for LAPC proposing conversion surgery was not well discussed. In this case, we achieve R0 resection combined with chemoradiation therapy and gemcitabine/nab-paclitaxel therapy. This regimen was also effective for LAPC and may be used to increase the population of conversion surgery by its high response rate.

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“…A regression index > 0.46 was observed in 15 (71%) responders and 5 (26%) nonresponders. It showed that the SUV based on FDG-PET/CT is a useful implement for predicting the response of treatment [39] .…”

Section: Staging: Wang Et Almentioning

confidence: 99%

“…Results showed that PET/CT play more important factors in designing the treatment plans for individual patient than conventional CT [38] . Kittaka et al [39] performed 18 F-FDG PET in patients classified as responders and nonresponders before and after preoperative CRT. A pre-CRT SUV > 4.7 was seen in 15 (71%) of 21 responders and in 6 (32%) of 19 nonresponders.…”

Section: Staging: Wang Et Almentioning

confidence: 99%

Advancement in treatment and diagnosis of pancreatic cancer with radiopharmaceuticals

Xu¹

2016

WJGO

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Pancreatic cancer (PC) is a major health problem. Conventional imaging modalities show limited accuracy for reliable assessment of the tumor. Recent researches suggest that molecular imaging techniques with tracers provide more biologically relevant information and are benefit for the diagnosis of the cancer. In addition, radiopharmaceuticals also play more important roles in treatment of the disease. This review summaries the advancement of the radiolabeled compounds in the theranostics of PC.

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Role of ¹⁸F‐Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Predicting the Pathologic Response to Preoperative Chemoradiation Therapy in Patients With Resectable T3 Pancreatic Cancer

Abstract: A better pathological response can be expected for pancreatic cancer patients who have a high regression index (≥ 0.46) and a high pre-CRT SUV (≥ 4.7). The SUV measurement using FDG-PET/CT is a useful tool for predicting the pathologic response to preoperative CRT.

Cited by 71 publications

References 55 publications

The Application of Functional Imaging Techniques to Personalise Chemoradiotherapy in Upper Gastrointestinal Malignancies

The Application of Functional Imaging Techniques to Personalise Chemoradiotherapy in Upper Gastrointestinal Malignancies

Locally advanced pancreatic cancer successfully treated by distal pancreatectomy with celiac axis resection (DP-CAR) after S-1 with radiation therapy followed by gemcitabine/nab-paclitaxel therapy: a case report

Advancement in treatment and diagnosis of pancreatic cancer with radiopharmaceuticals

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Role of 18F‐Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Predicting the Pathologic Response to Preoperative Chemoradiation Therapy in Patients With Resectable T3 Pancreatic Cancer

Abstract: A better pathological response can be expected for pancreatic cancer patients who have a high regression index (≥ 0.46) and a high pre-CRT SUV (≥ 4.7). The SUV measurement using FDG-PET/CT is a useful tool for predicting the pathologic response to preoperative CRT.

Cited by 71 publications

References 55 publications

The Application of Functional Imaging Techniques to Personalise Chemoradiotherapy in Upper Gastrointestinal Malignancies

The Application of Functional Imaging Techniques to Personalise Chemoradiotherapy in Upper Gastrointestinal Malignancies

Locally advanced pancreatic cancer successfully treated by distal pancreatectomy with celiac axis resection (DP-CAR) after S-1 with radiation therapy followed by gemcitabine/nab-paclitaxel therapy: a case report

Advancement in treatment and diagnosis of pancreatic cancer with radiopharmaceuticals

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Role of ¹⁸F‐Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Predicting the Pathologic Response to Preoperative Chemoradiation Therapy in Patients With Resectable T3 Pancreatic Cancer