Advances and Clinical Efficacy Evaluation Method on Neoadjuvant Chemotherapy in Patients with Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Shaoting ¹ , ZHU Zhaohui ² , LI Xiaoyi ³

1.Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China;;
2.PET Center, Peking Union Medical College, Beijing 100730, China;;
3.Department of Basic Surgery, Peking Union Medical College, Beijing 100730, China;

Corresponding author：

Keywords：

Gastric cancer; Neoadjuvant chemotherapy; Efficacy evaluation; Positron emission tomography

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Objective To investigate the advances and clinical efficacy evaluation method on neoadjuvant chemotherapy in patients with gastric cancer.
Methods Literatures on the advances and clinical efficacy evaluation method on neoadjuvant chemotherapy in patients with gastric cancer were reviewed and analyzed. The agreement between computed tomography (CT), endoscopic ultrasound (EUS), magnetic resonance imaging (MRI) and positron emission tomography (PET) and the results of histopathology and survival was analyzed.
Results CT and EUS were the method of efficacy evaluation commonly used at present, but the evaluation indexes and criteria were controversial, and the criteria for solid tumors seemed to be not feasible for gastric cancer. Diffusionweighted imaging (DWI) method needed more investigation, while PET held advantage in early selection of patients without response accurately.
Conclusion There is no uniform standard for clinical efficacy evaluation yet, so an integration of diverse imaging methods may be the best choice to improve the accuracy of neoadjuvant chemotherapy in patients with gastric cancer.

Citation： WANG Shaoting ,ZHU Zhaohui,LI Xiaoyi. Advances and Clinical Efficacy Evaluation Method on Neoadjuvant Chemotherapy in Patients with Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(2): 200-204. doi: Copy

1.	Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006; 355(1): 1120.
2.	Boige V, Pignon J, SaintAubert B, et al. Final results of a randomized trial comparing preoperative 5fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07FFCD 9703 trial [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4510.
3.	方育, 王亚军, 李非, 等. 奥沙利铂联合甲酰四氢叶酸钙和氟尿嘧啶新辅助化疗方案治疗进展期胃癌的研究 [J]. 中华胃肠外科杂志, 2006; 9(6): 510512.
4.	National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Gastric cancer (NCCN).v.2. 2009. http://www.nccn.org/professionals/physician_gls/PDF/gastric.pdf.
5.	Ninomiya Y, Yanagisawa A, Kato Y, et al. Histological indications of a favorable prognosis with faradvanced gastric carcinomas after preoperative chemotherapy [J]. J Cancer Res Clin Oncol, 1999; 125(12): 699706.
6.	Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy [J]. Cancer, 2003; 98(7): 15211530.
7.	Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging [J]. J Clin Oncol, 2001; 19(12): 30583065.
8.	Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial [J]. J Clin Oncol, 2003; 21(24): 46044610.
9.	Ott K, Weber WA, Lordick F, et al. Metabolic imaging predicts response, survival, and recurrence in adenocarcinomas of the esophagogastric junction [J]. J Clin Oncol, 2006; 24(29): 46924698.
10.	Lordick F, Ott K, Krause BJ, et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase Ⅱ trial [J]. Lancet Oncol, 2007; 8(9): 754755.
11.	Miller AB, Hoogstraten B, Staquet M, et al. Reporting results of cancer treatment [J]. Cancer, 1981; 47(1): 207214.
12.	Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors [J]. J Natl Cancer Inst, 2000; 92(3): 205216.
13.	Young H, Baum R, Cremerius U, et al. Measurement of clinical and subclinical tumour response using [18F]fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group [J]. Eur J Cancer, 1999; 35(13): 17731782.
14.	Choi H, Charnsangavej C, Faria SC, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria [J]. J Clin Oncol, 2007; 25(13): 17531759.
15.	严超, 朱正纲, 燕敏, 等. 内镜超声检查和多层螺旋CT对胃癌淋巴结转移状况的评估价值 [J]. 中华外科杂志, 2005; 43(3): 174176.
16.	严超, 朱正纲, 燕敏, 等. 多排CT 对早期胃癌术前评估的价值 [J]. 外科理论与实践, 2008; 13(1): 3439.
17.	Allum WH, Griffin SM, Watson A, et al. Guidelines for the management of oesophageal and gastric cancer [J]. Gut, 2002; 50(Suppl 5): 123.
18.	Shimizu1 K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the waterfilling method and multiplanar reconstruction: CThistologic correlation [J]. AJR Am J Roentgenol, 2005; 185(5): 11521158.
19.	Park SR, Lee JS, Kim CG, et al. Endoscopic ultrasound and computed tomography in restaging and predicting prognosis after neoadjuvant chemotherapy in patients with locally advanced gastric cancer [J]. Cancer, 2008; 112(11): 23682376.
20.	Di Fabio F, Pinto C, Rojas Llimpe FL, et al. The predictive value of 18FFDGPET early evaluation in patients with metastatic gastric adenocarcinoma treated with chemotherapy plus cetuximab [J]. Gastric Cancer, 2007; 10(4): 221227.
21.	Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma－2nd English edition: response assessment of chemotherapy and radiotherapy for gastric carcinoma: clinical criteria [J]. Gastric Cancer, 2001; 4(1): 18.
22.	Kurihara M, Aiko T. The new Japanese classification of gastric carcinoma: revised explanation of “response assessment of chemotherapy and radiotherapy for gastric carcinoma” [J]. Gastric Cancer, 2001; 4(1): 913.
23.	Benjamin RS, Choi H, Macapinlac HA, et al. We should desist using RECIST, at least in GIST [J]. J Clin Oncol, 2007; 25 (13): 17601764.
24.	Lee SM, Kim SH, Lee JM, et al. Usefulness of CT volumetry for primary gastric lesions in predicting pathologic response to neoadjuvant chemotherapy in advanced gastric cancer [J]. Abdom Imaging, 2009; 34(4): 430440.
25.	严超, 朱正纲, 燕敏，等. 内镜超声检查对胃癌术前分期的价值 [J]. 中国内镜杂志, 2003; 9(5): 3236.
26.	Mesenas S, Vu C, McStay M, et al. A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy [J]. Dis Esophagus, 2008; 21(1): 3742.
27.	Blackshaw G, Lewis WG, Hopper AN, et al. Prospective comparison of endosonography, computed tomography, and histopathological stage of junctional oesophagogastric cancer [J]. Clin Radiol, 2008; 63(10): 10921098.
28.	Motohara T, Semelka RC. MRI in staging of gastric cancer [J]. Abdom Imaging, 2002; 27(4): 376383.
29.	Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review [J]. J Clin Oncol, 2007; 25(15): 21072116.
30.	Arocena MG, Barturen A, Bujanda L, et al. MRI and endoscopic ultrasonography in the staging of gastric cancer [J]. Rev Esp Enferm Dig, 2006; 98(8): 582590.
31.	Roth Y, Tichler T, Kostenich G, et al. Highbvalue diffusionweighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3): 685692.
32.	Thoeny HC, De Keyzer F, Chen F, et al. Diffusionweighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats [J]. Radiology, 2005; 234(3): 756764.
33.	Naganawa S, Sato C, Kumada H, et al. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix [J]. Eur Radiol, 2005; 15(1): 7178.
34.	Batchelor TT, Sorensen AG, di Tomaso E, et al. AZD2171, a panVEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients [J]. Cancer Cell, 2007; 11(1): 8395.
35.	Esteves FP, Schuster DM, Halkar RK. Gastrointestinal tract malignancies and positron emission tomography: an overview [J]. Semin Nucl Med, 2006; 36(2):169181.
36.	Dehdashti F, Siegel BA. Neoplasms of the esophagus and stomach [J]. Semin Nucl Med, 2004; 34(3): 198208.
37.	Yun M, Lim JS, Noh SH, et al. Lymph node staging of gastric cancer using 18FFDG PET: a comparison study with CT [J]. J Nucl Med, 2005; 46(10): 15821588.
38.	Kim SK, Kang KW, Lee JS, et al. Assessment of lymph node metastases using 18FFDG PET in patients with advanced gastric cancer [J]. Eur J Nucl Med Mol Imaging, 2006; 33(2): 148155.
39.	Chen J, Cheong JH, Yun MJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography [J].Cancer, 2005; 103(11): 23832390.
40.	Suttie SA, Welch AE, Park KG. Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastrooesophageal junction carcinoma [J]. Eur J Surg Oncol, 2009; 35(10): 10191029.
41.	Yun M, Choi HS, Yoo E, et al. The role of gastric distention in differentiating recurrent tumor from physiologic uptake in the remnant stomach on 18FFDG PET [J]. J Nucl Med, 2005; 46(6): 953957.
42.	Tian J, Chen L, Wei B, et al. The value of vesicant 18Ffluorodeoxyglucose positron emission tomography (18FFDG PET) in gastric malignancies [J]. Nucl Med Commun, 2004; 25(8): 825831.
43.	Imperiale A, Cimarelli S, Sellem DB, et al. Focal F18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images [J]. Clin Nucl Med, 2006; 31(12): 835837.
44.	Zhu Z, Li F, Mao Y, et al. Improving evaluation of primary gastric malignancies by distending the stomach with milk immediately before 18FFDG PET scanning [J]. J Nucl Med Technol, 2008; 36(1): 2529.
45.	Zhu Z, Li F, Zhuang H. Gastric distension by ingesting food is useful in the evaluation of primary gastric cancer by FDG PET [J]. Clin Nucl Med, 2007; 32(2): 106109.
46.	Ott K, Lordick F, Herrmann K, et al. The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies [J]. Gastric Cancer, 2008; 11(1): 19.
47.	季加孚. 胃癌外科的现状与发展趋势 [J]. 中国普外基础与临床杂志, 2006; 13(1): 13.

1. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006; 355(1): 1120.
2. Boige V, Pignon J, SaintAubert B, et al. Final results of a randomized trial comparing preoperative 5fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07FFCD 9703 trial [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4510.
3. 方育, 王亚军, 李非, 等. 奥沙利铂联合甲酰四氢叶酸钙和氟尿嘧啶新辅助化疗方案治疗进展期胃癌的研究 [J]. 中华胃肠外科杂志, 2006; 9(6): 510512.
4. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Gastric cancer (NCCN).v.2. 2009. http://www.nccn.org/professionals/physician_gls/PDF/gastric.pdf.
5. Ninomiya Y, Yanagisawa A, Kato Y, et al. Histological indications of a favorable prognosis with faradvanced gastric carcinomas after preoperative chemotherapy [J]. J Cancer Res Clin Oncol, 1999; 125(12): 699706.
6. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy [J]. Cancer, 2003; 98(7): 15211530.
7. Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging [J]. J Clin Oncol, 2001; 19(12): 30583065.
8. Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial [J]. J Clin Oncol, 2003; 21(24): 46044610.
9. Ott K, Weber WA, Lordick F, et al. Metabolic imaging predicts response, survival, and recurrence in adenocarcinomas of the esophagogastric junction [J]. J Clin Oncol, 2006; 24(29): 46924698.
10. Lordick F, Ott K, Krause BJ, et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase Ⅱ trial [J]. Lancet Oncol, 2007; 8(9): 754755.
11. Miller AB, Hoogstraten B, Staquet M, et al. Reporting results of cancer treatment [J]. Cancer, 1981; 47(1): 207214.
12. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors [J]. J Natl Cancer Inst, 2000; 92(3): 205216.
13. Young H, Baum R, Cremerius U, et al. Measurement of clinical and subclinical tumour response using [18F]fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group [J]. Eur J Cancer, 1999; 35(13): 17731782.
14. Choi H, Charnsangavej C, Faria SC, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria [J]. J Clin Oncol, 2007; 25(13): 17531759.
15. 严超, 朱正纲, 燕敏, 等. 内镜超声检查和多层螺旋CT对胃癌淋巴结转移状况的评估价值 [J]. 中华外科杂志, 2005; 43(3): 174176.
16. 严超, 朱正纲, 燕敏, 等. 多排CT 对早期胃癌术前评估的价值 [J]. 外科理论与实践, 2008; 13(1): 3439.
17. Allum WH, Griffin SM, Watson A, et al. Guidelines for the management of oesophageal and gastric cancer [J]. Gut, 2002; 50(Suppl 5): 123.
18. Shimizu1 K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the waterfilling method and multiplanar reconstruction: CThistologic correlation [J]. AJR Am J Roentgenol, 2005; 185(5): 11521158.
19. Park SR, Lee JS, Kim CG, et al. Endoscopic ultrasound and computed tomography in restaging and predicting prognosis after neoadjuvant chemotherapy in patients with locally advanced gastric cancer [J]. Cancer, 2008; 112(11): 23682376.
20. Di Fabio F, Pinto C, Rojas Llimpe FL, et al. The predictive value of 18FFDGPET early evaluation in patients with metastatic gastric adenocarcinoma treated with chemotherapy plus cetuximab [J]. Gastric Cancer, 2007; 10(4): 221227.
21. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma－2nd English edition: response assessment of chemotherapy and radiotherapy for gastric carcinoma: clinical criteria [J]. Gastric Cancer, 2001; 4(1): 18.
22. Kurihara M, Aiko T. The new Japanese classification of gastric carcinoma: revised explanation of “response assessment of chemotherapy and radiotherapy for gastric carcinoma” [J]. Gastric Cancer, 2001; 4(1): 913.
23. Benjamin RS, Choi H, Macapinlac HA, et al. We should desist using RECIST, at least in GIST [J]. J Clin Oncol, 2007; 25 (13): 17601764.
24. Lee SM, Kim SH, Lee JM, et al. Usefulness of CT volumetry for primary gastric lesions in predicting pathologic response to neoadjuvant chemotherapy in advanced gastric cancer [J]. Abdom Imaging, 2009; 34(4): 430440.
25. 严超, 朱正纲, 燕敏，等. 内镜超声检查对胃癌术前分期的价值 [J]. 中国内镜杂志, 2003; 9(5): 3236.
26. Mesenas S, Vu C, McStay M, et al. A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy [J]. Dis Esophagus, 2008; 21(1): 3742.
27. Blackshaw G, Lewis WG, Hopper AN, et al. Prospective comparison of endosonography, computed tomography, and histopathological stage of junctional oesophagogastric cancer [J]. Clin Radiol, 2008; 63(10): 10921098.
28. Motohara T, Semelka RC. MRI in staging of gastric cancer [J]. Abdom Imaging, 2002; 27(4): 376383.
29. Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review [J]. J Clin Oncol, 2007; 25(15): 21072116.
30. Arocena MG, Barturen A, Bujanda L, et al. MRI and endoscopic ultrasonography in the staging of gastric cancer [J]. Rev Esp Enferm Dig, 2006; 98(8): 582590.
31. Roth Y, Tichler T, Kostenich G, et al. Highbvalue diffusionweighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3): 685692.
32. Thoeny HC, De Keyzer F, Chen F, et al. Diffusionweighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats [J]. Radiology, 2005; 234(3): 756764.
33. Naganawa S, Sato C, Kumada H, et al. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix [J]. Eur Radiol, 2005; 15(1): 7178.
34. Batchelor TT, Sorensen AG, di Tomaso E, et al. AZD2171, a panVEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients [J]. Cancer Cell, 2007; 11(1): 8395.
35. Esteves FP, Schuster DM, Halkar RK. Gastrointestinal tract malignancies and positron emission tomography: an overview [J]. Semin Nucl Med, 2006; 36(2):169181.
36. Dehdashti F, Siegel BA. Neoplasms of the esophagus and stomach [J]. Semin Nucl Med, 2004; 34(3): 198208.
37. Yun M, Lim JS, Noh SH, et al. Lymph node staging of gastric cancer using 18FFDG PET: a comparison study with CT [J]. J Nucl Med, 2005; 46(10): 15821588.
38. Kim SK, Kang KW, Lee JS, et al. Assessment of lymph node metastases using 18FFDG PET in patients with advanced gastric cancer [J]. Eur J Nucl Med Mol Imaging, 2006; 33(2): 148155.
39. Chen J, Cheong JH, Yun MJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography [J].Cancer, 2005; 103(11): 23832390.
40. Suttie SA, Welch AE, Park KG. Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastrooesophageal junction carcinoma [J]. Eur J Surg Oncol, 2009; 35(10): 10191029.
41. Yun M, Choi HS, Yoo E, et al. The role of gastric distention in differentiating recurrent tumor from physiologic uptake in the remnant stomach on 18FFDG PET [J]. J Nucl Med, 2005; 46(6): 953957.
42. Tian J, Chen L, Wei B, et al. The value of vesicant 18Ffluorodeoxyglucose positron emission tomography (18FFDG PET) in gastric malignancies [J]. Nucl Med Commun, 2004; 25(8): 825831.
43. Imperiale A, Cimarelli S, Sellem DB, et al. Focal F18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images [J]. Clin Nucl Med, 2006; 31(12): 835837.
44. Zhu Z, Li F, Mao Y, et al. Improving evaluation of primary gastric malignancies by distending the stomach with milk immediately before 18FFDG PET scanning [J]. J Nucl Med Technol, 2008; 36(1): 2529.
45. Zhu Z, Li F, Zhuang H. Gastric distension by ingesting food is useful in the evaluation of primary gastric cancer by FDG PET [J]. Clin Nucl Med, 2007; 32(2): 106109.
46. Ott K, Lordick F, Herrmann K, et al. The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies [J]. Gastric Cancer, 2008; 11(1): 19.
47. 季加孚. 胃癌外科的现状与发展趋势 [J]. 中国普外基础与临床杂志, 2006; 13(1): 13.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Advances and Clinical Efficacy Evaluation Method on Neoadjuvant Chemotherapy in Patients with Gastric Cancer

Abstract Full text Figures/Tables Video References Cited by

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