Table 4.
Clinical studies using fluorodeoxyglucose‐positron emission tomography for response assessment after induction chemotherapy
| Study | No. of patients | Induction chemotherapy | Second scan (time after completion of chemotherapy) | Parameter | Lesion | Measure | Cutoff point | Reference standard | Accuracy |
|---|---|---|---|---|---|---|---|---|---|
| Brun et al50 (2002) | 10 | 1 cycle cisplatin, 5‐FU | 0‐5 d |
Metabolic rate SUVpeak |
Primary tumor | Absolute | Median | Follow‐up (median 3.3 yr) |
Local control < mean 96% ≥ mean 62% (P = .007) Local control < mean 91% ≥ mean 68% (P = .07) |
| Chepeha et al37 (2009) | 12 | 1 cycle cis‐/carboplatin, 5‐FU | 3 wk | SUVmax (3 × 3 pixel) | Primary tumor | Visual estimation of decrease | 50% | Endoscopy | Substantial agreement |
| Kikuchi et al53 (2011) | 15 | 1 cycle S‐1 and CDGP | Mean 20.5 (14‐31) d | SUVmax | Primary tumor and largest lymph node |
Absolute Decrease |
3.5 55.5.% |
<10% viable tumor in tumor bed in surgical specimen |
Sens 71% Spec 89% PPV 71% NPV 89% Sens 86% Spec 95% PPV 86% NPV 95% |
| Semrau et al58 (2015) | 47 | 1 cycle docetaxel, cisplatin | 3 wk | SUVmax | Primary tumor | Decrease | 20% | >30% reduction in superficial tumor extension |
Sens 97% Spec 56% PPV 90% NPV 83% |
| Wong et al59 (2016) | 20 | 2 cycles docetaxel, cisplatin, 5‐FU | After first cycle | TLG | Primary tumor | Decrease | 60% | Follow‐up 3 mo after completion of chemoradiation |
Sens 73% Spec 80% |
| Gavid et al57 (2015) | 21 | 2‐3 cycles docetaxel, cisplatin, 5‐FU | After first cycle | SUVmax | Primary tumor | Decrease | 30% | ≥70% response with endoscopy after end of induction chemotherapy |
Sens 69% Spec 63% PPV 75% NPV 90% |
| Yoon et al55 (2011) | 21 | 2 cycles S‐1 and cisplatin | 2‐4 wk | SUVmax | Primary tumor |
Absolute Decrease |
4.8 65% |
RECIST 2 mo after completion chemoradiation |
Sens 94% Spec 100% PPV 100% NPV 80% Sens 88% Spec 100% PPV 100% NPV 67% |
| Powell et al44 (2013) | 9 | 2 cyclescisplatin, 5‐FU | NA | – |
Primary tumor Lymph node |
Visual residual avidity | Yes / no | Follow‐up and neck dissection |
Sens NA Spec 89% PPV NA NPV 100% Sens 100% Spec 88% PPV 50% NPV 89% |
| Dalsaso et al49 (2000) | 19 | 2‐3 cycles paclitaxel and cisplatin | SUVmean | Primary tumor | Decrease | – | 4 biopsies from 4 separate sites within pretreatment tumor area | Pathologic complete responders mean reduction 82%, nonresponders mean reduction 35% (P = .01) | |
| McCollum et al51 (2004) | 26 | 3 cycles cisplatin, 5‐FU +/‐ docetaxel | NA | ‐ | Primary tumor | Visual estimation of residual tumor | Yes / no | Biopsy of primary tumor site |
Sens 100% Spec 65% PPV 27% NPV 100% |
| Abgral et al46 (2012) | 15 | 3 cycles docetaxel, cisplatin, 5‐FU | Mean 15.8 ± 4.9 d after second cycle | SUVmax | Primary tumor | Decrease |
EORTC criteria; metabolic response: SUVmax decrease >25% |
1‐y event‐free survival (mean follow‐up 14.3 ± 6.6 mo) | Metabolic responders 0%, nonresponders 27% survived 1 y |
| Yu et al56 (2014) | 28 | 3 cycles docetaxel, cisplatin, 5‐FU | 2‐3 wk |
MTV TLG |
Primary tumor | Decrease | 42% 55% | Event‐free survival |
Sens 67% Spec 90% Sens 63% Spec 90% |
Abbreviations: 5‐FU, 5‐fluorouracil; CDGP, XXX; EORTC, European Organisation for Research and Treatment of Cancer; MTV, metabolic tumor volume; NA, not available; NPV, negative predictive value; PPV, positive predictive value; RECIST, Response Evaluation Criteria in Solid Tumors; Sens, sensitivity; Spec, specificity; SUVmax, standardized uptake value maximum; SUVpeak, standardized uptake value peak; TLG, total lesion glycolysis.