Follow up results of a prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer
AuthorNg, SP; Tan, J; Osbourne, G; Williams, L; Bressel, MAB; Hicks, RJ; Lau, EWF; Chu, J; Ngan, SYK; Leong, T
Source TitleClinical and Translational Radiation Oncology
PublisherELSEVIER IRELAND LTD
Medicine and Radiology
Document TypeJournal Article
CitationsNg, S. P., Tan, J., Osbourne, G., Williams, L., Bressel, M. A. B., Hicks, R. J., Lau, E. W. F., Chu, J., Ngan, S. Y. K. & Leong, T. (2017). Follow up results of a prospective study to evaluate the impact of FDG-PET on CT-based radiotherapy treatment planning for oesophageal cancer. CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY, 2, pp.76-82. https://doi.org/10.1016/j.ctro.2017.01.008.
Access StatusOpen Access
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.
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