Low metabolic activity in primary gastric adenocarcinoma is associated with resistance to chemoradiation and the presenc
- PDF / 1,473,935 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 114 Downloads / 199 Views
ORIGINAL ARTICLE
Low metabolic activity in primary gastric adenocarcinoma is associated with resistance to chemoradiation and the presence of signet ring cells Kazuto Harada1,8 · Madhavi Patnana2 · Xuemei Wang3 · Masaaki Iwatsuki1,8 · Mariela A. Blum Murphy1 · Meina Zhao1 · Prajnan Das4 · Bruce D. Minsky4 · Brian Weston5 · Jeffrey H. Lee5 · Manoop S. Bhutani5 · Jeannelyn S. Estrella6 · Namita Shanbhag1 · Naruhiko Ikoma7 · Brian D. Badgwell7 · Jaffer A. Ajani1 Received: 18 November 2019 / Accepted: 17 March 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purposes Preoperative chemoradiation is a potential treatment option for localized gastric adenocarcinoma (GAC). Currently, the response to chemoradiation cannot be predicted. We analyzed the pretreatment maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) on positron emission tomography/computed tomography as potential predictors of the response to chemoradiation. Methods We analyzed the S UVmax and TLG data from 59 GAC patients who received preoperative chemoradiation. We used logistic regression models to predict a pathologic complete response (pCR) and Kaplan–Meier curves to determine overall survival among patients with high and low SUVmax or TLG. Results Twenty-nine patients (49%) had Siewert type III adenocarcinoma and 30 (51%) had tumors located in the lower stomach. Forty-one patients had poorly differentiated GAC, and 26 had signet ring cells. The median SUVmax was 7.3 (0–28.2) and the median TLG was 56.6 (0–1881.5). Patients with signet ring cells had a low pCR rate, as well as a low SUVmax and TLG. In the multivariable logistic regression model, high SUVmax was a predictor of pCR (odds ratio = 11.1, 95% confidence interval = 2.12–50.0, p = 0.004). Overall survival was not associated with the SUVmax (log-rank p = 0.69) or TLG (log-rank p = 0.85) Conclusion A high SUVmax was associated with sensitivity to chemoradiation and pCR in GAC, and signet ring cells seemed to confer resistance. Keywords Gastric adenocarcinoma · Positron emission tomography (PET) · Total lesion glycolysis (TLG) · Chemoradiation
* Jaffer A. Ajani [email protected] 1
2
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
3
Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
4
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
5
Department of Gastroenterology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
6
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
7
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
8
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto Uni
Data Loading...
