World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Original Article

Volume 1, Number 2, April 2010, pages 66-67

F-18-FDG and C-11-Choline Positron Emission Tomography in Human Esophago-Gastric Cancer: Prediction of Response to Therapy

**Table 1.** Patients, tumour characteristics, staging and chemotherapy regimens
Patient	Sex	Age	Tumour Location	Tumour Histology	Pre Treatment AJCC Stage	Staging Modality	Chemotherapy	Chemotherapy Regime	Chemotherapy Cycles Completed	Re staging (CT)	Further Treatment
(M = male; F = female; E = esophagus; EGJ = esophago-gastric junction; A = adenocarcinoma; S = squamous cell carcinoma; CT = computerised tomography; EUS = endoscopic ultrasound; E = epirubicin; C = cisplatin; F =5-fluorouracil; X = capecitabine; M = mitomycin-C; CRT = chemoradiotherapy)
1	M	55.5	E	A	III	CT	MCX	Palliative	3	-	-
2	M	54.4	EGJ	A	IIA	CT	CF	Neoadjuvant	2	IIA	Surgery
3	F	67.6	E	A	III	CT	CF	Neoadjuvant	2	-	Surgery
4	M	50.9	EGJ	A	IIA	CT	CF	Neoadjuvant	2	IIA	Surgery
5	M	50.1	E	S	IIA	CT/EUS	CF	Neoadjuvant	2	-	Surgery
6	F	69.4	E	A	IIA	CT	CX	Neoadjuvant	2	IIA	CRT
7	M	56.5	EGJ	A	III	CT/EUS	CX	Neoadjuvant	2	III	CRT
8	M	61.9	E	A	IVB	CT	ECF	Palliative	0	-	-
9	M	78.1	EGJ	A	IVB	CT	ECF	Palliative	4	IVB	ECF
10	F	70.7	E	A	III	CT	CX	Neoadjuvant	2	-	Surgery
11	M	52.5	EGJ	A	IVA	CT	CX	Neoadjuvant	2	-	Surgery
12	M	54.3	E	A	IIA	CT/EUS	CX	Neoadjuvant	2	IIA	Surgery
13	M	63.3	EGJ	A	IIA	CT	ECX	Neoadjuvant	3	III	CRT
14	F	60.0	EGJ	A	IVB	CT	MCX	Palliative	3	IVB	MCX
15	F	67.9	E	S	IVA	CT	MCX	Neoadjuvant	3	III	Surgery
16	F	64.7	E	A	III	CT	CX	Neoadjuvant	2	III	Surgery
17	M	57.9	E	A	III	CT	CX	Neoadjuvant	2	IVA	CRT
18	M	59.7	EGJ	A	III	CT	ECX	Neoadjuvant	3	IVA	CRT

Table 1. Patients, tumour characteristics, staging and chemotherapy regimens

Patient

Sex

Age

Tumour Location

Tumour Histology

Pre Treatment AJCC Stage

Staging Modality

Chemotherapy

Chemotherapy Regime

Chemotherapy Cycles Completed

Re staging (CT)

Further Treatment

(M = male; F = female; E = esophagus; EGJ = esophago-gastric junction; A = adenocarcinoma; S = squamous cell carcinoma; CT = computerised tomography; EUS = endoscopic ultrasound; E = epirubicin; C = cisplatin; F =5-fluorouracil; X = capecitabine; M = mitomycin-C; CRT = chemoradiotherapy)

55.5

III

MCX

Palliative

54.4

EGJ

IIA

Neoadjuvant

IIA

Surgery

67.6

III

Neoadjuvant

Surgery

50.9

EGJ

IIA

Neoadjuvant

IIA

Surgery

50.1

IIA

CT/EUS

Neoadjuvant

Surgery

69.4

IIA

Neoadjuvant

IIA

CRT

56.5

EGJ

III

CT/EUS

Neoadjuvant

III

CRT

61.9

IVB

ECF

Palliative

78.1

EGJ

IVB

ECF

Palliative

IVB

ECF

70.7

III

Neoadjuvant

Surgery

52.5

EGJ

IVA

Neoadjuvant

Surgery

54.3

IIA

CT/EUS

Neoadjuvant

IIA

Surgery

63.3

EGJ

IIA

ECX

Neoadjuvant

III

CRT

60.0

EGJ

IVB

MCX

Palliative

IVB

MCX

67.9

IVA

MCX

Neoadjuvant

III

Surgery

64.7

III

Neoadjuvant

III

Surgery

57.9

III

Neoadjuvant

IVA

CRT

59.7

EGJ

III

ECX

Neoadjuvant

IVA

CRT

**Table 2.** Survival, Pathological Response, Resection Status and Ki-67 Status
Patient	Chemotherapy Regime	TRG	Resection Status	Pathological Stage	Survival (months)	Status at Follow Up	Median Ki-67 Tumour Nucleii in pre-treatment biopsy (± SD)	High Power Fields Counted	Mean ki-67 Tumour Nuclei in Resection Specimen (± SD)	High Power Fields Counted	% Δ in Ki-67 Staining
1	Palliative				6.0	Dead	236 (55)	5
2	Neoadjuvant	4	R₁	T3 N1 Mx	7.6	Dead
3	Neoadjuvant	3	R₁	T2 N1 Mx	8.4	Dead	117 (48)	5	85 (44)	6	-27.4
4	Neoadjuvant	3	R₀	T3 N1 Mx	15.8	Dead	228 (72)	4	203 (41)	5	-11.0
5	Neoadjuvant	5	R₀	T3 N0 Mx	25.1	Alive	276 (39)	5	184 (46)	6	-33.3
6	Neoadjuvant				24.4	Alive	395 (43)	5
7	Neoadjuvant				17.9	Dead	186 (43)	5
8	Palliative				0.3	Dead	741 (79)	3
9	Palliative				9.2	Dead	466 (51)	5
10	Neoadjuvant	4	R₁	T3 N1 Mx	11.9	Dead	575 (63)	4	135 (24)	15	-76.5
11	Neoadjuvant	2	R₀	T3 N1 Mx	20.0	Alive	616 (31)	4	73 (35)	7	-88.1
12	Neoadjuvant	4	R₁	T3 N1 Mx	19.8	Alive	194 (82)	5	149 (30)	7	-23.2
13	Neoadjuvant				18.2	Alive	437 (107)	5
14	Palliative				10.0	Dead	35 (5)	2
15	Neoadjuvant	2	R₀	T2 N0 Mx	16.4	Alive	209 (42)	5	0 (0)	5	-100.0
16	Neoadjuvant	4	R₀	T3 N1 Mx	15.4	Alive
17	Neoadjuvant				13.8	Alive	536 (76)	4
18	Neoadjuvant				13.7	Alive	437 (158)	5

Table 2. Survival, Pathological Response, Resection Status and Ki-67 Status

Patient

Chemotherapy Regime

TRG

Resection Status

Pathological Stage

Survival (months)

Status at Follow Up

Median Ki-67 Tumour Nucleii in pre-treatment biopsy (± SD)

High Power Fields Counted

Mean ki-67 Tumour Nuclei in Resection Specimen (± SD)

High Power Fields Counted

% Δ in Ki-67 Staining

Palliative

6.0

Dead

236 (55)

Neoadjuvant

R₁

T3 N1 Mx

7.6

Dead

Neoadjuvant

R₁

T2 N1 Mx

8.4

Dead

117 (48)

85 (44)

-27.4

Neoadjuvant

R₀

T3 N1 Mx

15.8

Dead

228 (72)

203 (41)

-11.0

Neoadjuvant

R₀

T3 N0 Mx

25.1

Alive

276 (39)

184 (46)

-33.3

Neoadjuvant

24.4

Alive

395 (43)

Neoadjuvant

17.9

Dead

186 (43)

Palliative

0.3

Dead

741 (79)

Palliative

9.2

Dead

466 (51)

Neoadjuvant

R₁

T3 N1 Mx

11.9

Dead

575 (63)

135 (24)

-76.5

Neoadjuvant

R₀

T3 N1 Mx

20.0

Alive

616 (31)

73 (35)

-88.1

Neoadjuvant

R₁

T3 N1 Mx

19.8

Alive

194 (82)

149 (30)

-23.2

Neoadjuvant

18.2

Alive

437 (107)

Palliative

10.0

Dead

35 (5)

Neoadjuvant

R₀

T2 N0 Mx

16.4

Alive

209 (42)

0 (0)

-100.0

Neoadjuvant

R₀

T3 N1 Mx

15.4

Alive

Neoadjuvant

13.8

Alive

536 (76)

Neoadjuvant

13.7

Alive

437 (158)

**Table 3a.** Median Initial Tumor PET Tracer Uptake and Survival
Quantification	Tracer	Median Uptake (± SD)	Survival, months (± SD)	p	n
SUV	F-18 FDG	0.17 (0.06)	< median 14.8 (2.0) > median 17.2 (2.7	0.70	18
	C-11 Choline	0.15 (0.01)	< median 19.3 (2.7) > median 11.5 (2.3)	0.11	16

Table 3a. Median Initial Tumor PET Tracer Uptake and Survival

Quantification

Tracer

Median Uptake (± SD)

Survival, months (± SD)

SUV

F-18 FDG

0.17 (0.06)

< median 14.8 (2.0)
> median 17.2 (2.7

0.70

C-11 Choline

0.15 (0.01)

< median 19.3 (2.7)
> median 11.5 (2.3)

0.11

**Table 3b.** Median % Δ in SUV PET Tumor Tracer Uptake at Seven and 14 days into the First Cycle of Chemotherapy and Survival
PET Timing	Tracer	Median % Δ SUV (± SD)	Survival, months (± SD)	p	n
Day 7	F-18 FDG	-3.3 (81.9)	< Median 15.0 (2.3) > Median 20.7 (2.7)	0.43	13
	C-11 Choline	0.0 (24.1)	< Median 21.3 (3.4) > Median 14.1 (2.1)	0.24	11
Day 14	F-18 FDG	-17.1 (28.3)	< Median 18.1 (1.2) > Median 17.2 (3.3)	0.41	12
	C-11 Choline	-0.2 (36.9)	< Median 21.1 (3.4) > Median 13.2 (2.1)	0.16	9

Table 3b. Median % Δ in SUV PET Tumor Tracer Uptake at Seven and 14 days into the First Cycle of Chemotherapy and Survival

PET Timing

Tracer

Median % Δ SUV (± SD)

Survival, months (± SD)

Day 7

F-18 FDG

-3.3 (81.9)

< Median 15.0 (2.3)
> Median 20.7 (2.7)

0.43

C-11 Choline

0.0 (24.1)

< Median 21.3 (3.4)
> Median 14.1 (2.1)

0.24

Day 14

F-18 FDG

-17.1 (28.3)

< Median 18.1 (1.2)
> Median 17.2 (3.3)

0.41

C-11 Choline

-0.2 (36.9)

< Median 21.1 (3.4)
> Median 13.2 (2.1)

0.16