Efficacy of ¹⁸F-Fluoro-2-Deoxyglucose Positron Emission Tomography as a Predictor of Treatment Response to Neoadjuvant S-1 + Oxaliplatin Chemotherapy for Gastric Cancer
Year: 2025
Type: article
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.
Authors: Urakawa, Naoki, 裏川, 直樹, ウラカワ, ナオキ, Kanaji, Shingo, 金治, 新悟, カナジ, シンゴ, Sawada, Ryuichiro, 澤田, 隆一郎, サワダ, リュウイチロウ, Koterazawa, Yasufumi, 小寺澤, 康文, コテラザワ, ヤスフミ, Ikeda, Taro, 池田, 太郎, イケダ, タロウ, Harada, Hitoshi, 原田, 仁, ハラダ, ヒトシ, Goto, Hironobu, 後藤, 裕信, ゴトウ, ヒロノブ, Hasegawa, Hiroshi, 長谷川, 寛, ハセガワ, ヒロシ, Yamashita, Kimihiro, 山下, 公大, ヤマシタ, キミヒロ, Matsuda, Takeru, 松田, 武, マツダ, タケル, Kakeji, Yoshihiro, 掛地, 吉弘, カケジ, ヨシヒロ
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7027916333
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