Response rate and diagnostic accuracy of early PET-CT during neo-adjuvant therapies in oesophageal adenocarcinoma: A systematic review and meta-analysis.

摘要: PURPOSE Only 25% of oesophageal adenocarcinoma (OAC) patients have a pathological response to neo-adjuvant therapy (NAT) before oesophagectomy. Early assessment using PET imaging may help guide management these patients. We performed systematic review and meta-analysis synthesise the evidence detailing rate diagnostic accuracy early PET-CT assessment. METHODS systematically searched several databases including MEDLINE Embase. Studies with mixed cohorts histology, tumour location repeat after more than one cycle NAT were excluded. Reference standard was defined by Becker or Mandard classifications. Primary outcome metabolic reduction in maximum standardised uptake value (SUVmax) 35%. Secondary treatment prediction, as sensitivity specificity this threshold. Quality also assessed. Random-effects pooled rates accuracy. This study registered PROSPERO (CRD42019147034). RESULTS Overall, 1341 articles screened, 6 studies eligible for analysis. These reported data 518 (aged 27-78 years; 452 [87.3%] men) between 2005 2020. Pooled predict 77.2% (95% CI 53.2%-100%). Significant heterogeneity existed (I2  = 80.6% 38.9%-93.8%), P = .006). 75.0% 68.2%-82.5%), however, no significant  = 0.0% 0.0%-67.4%), P = .73). CONCLUSION High-quality is lacking, few met inclusion criteria review. The SUVmax threshold 35% suboptimal varied widely. However, consistent across 75.0%, suggesting better predictor resistance than of pathological response. Further research required define optimal PET-guided decisions OAC.