Efficacy of 18F-Fluoro-2-Deoxyglucose Positron Emission Tomography as a Predictor of Treatment Response to Neoadjuvant S-1 + Oxaliplatin Chemotherapy for Gastric Cancer

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-04-24 DOI:10.1002/cnr2.70190

Naoki Urakawa, Shingo Kanaji, Ryuichiro Sawada, Yasufumi Koterazawa, Taro Ikeda, Hitoshi Harada, Hironobu Goto, Hiroshi Hasegawa, Kimihiro Yamashita, Takeru Matsuda, Yoshihiro Kakeji

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Abstract

Background

Neoadjuvant chemotherapy is widely recognized as the established treatment for advanced gastric cancer. However, predicting its efficacy before surgery remains challenging.

Aim

The present study aimed to evaluate the effectiveness of 18F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) as a predictor of treatment response to the S-1+Oxaliplatin regimen (SOX).

Methods and Results

Thirty patients who underwent gastrectomy following neoadjuvant SOX between January 2021 and July 2023 were included. Patients underwent FDG-PET pre- and postsurgery. The maximum standardized uptake value (SUVmax) from FDG-PET was examined in relation to histological tumor response and prognosis. SUVmax decreased significantly after chemotherapy in all patients (p < 0.001), especially in those with Grade 1a, 2, and 3 tumors (p < 0.05). SUV reduction increased stepwise with the histological response grade. Optimal cut-off values for the percentage decrease in SUVmax (ΔSUVmax) predictive of histologic efficacy were identified as 53% (area under curve 0.855, p = 0.0018) for Grade 1b or higher and 75% (area under curve 0.806, p = 0.0044) for Grade 2 or higher. Patients with ΔSUVmax > 50% had improved recurrence-free survival (p = 0.027).

Conclusion

FDG-PET may be useful as a predictor of treatment response in neoadjuvant SOX therapy for gastric cancer. The determination of the optimal ΔSUVmax value may enhance the precision of histological tumor response prediction.

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18f -氟-2-脱氧葡萄糖正电子发射断层扫描作为胃癌新辅助S-1 +奥沙利铂化疗反应预测因子的疗效

背景新辅助化疗被广泛认为是晚期胃癌的治疗方法。然而，在手术前预测其疗效仍然具有挑战性。目的本研究旨在评估18f -氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）作为S-1+奥沙利铂治疗方案（SOX）治疗反应的预测指标的有效性。方法和结果纳入了2021年1月至2023年7月期间接受新辅助SOX术后胃切除术的30例患者。患者术前和术后均行FDG-PET检查。FDG-PET检测的最大标准化摄取值（SUVmax）与组织学肿瘤反应和预后的关系。化疗后所有患者的SUVmax均显著降低（p < 0.001），尤其是1a级、2级和3级肿瘤患者（p < 0.05）。随着组织学反应等级的增加，SUV的减少逐渐增加。1b级及以上的SUVmax下降百分比（ΔSUVmax）预测组织学疗效的最佳临界值为53%（曲线下面积0.855,p = 0.0018）， 2级及以上的SUVmax下降百分比为75%（曲线下面积0.806,p = 0.0044）。ΔSUVmax >； 50%的患者无复发生存率提高（p = 0.027）。结论FDG-PET可作为胃癌新辅助SOX治疗疗效的预测指标。确定最佳ΔSUVmax值可提高组织学肿瘤反应预测的精度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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