A trial looking at PET scanning to help decide the stage of oesophageal cancer before treatment

Cancer type:

Oesophageal cancer

Status:

Results

Phase:

Phase 3

This trial was trying to find out if a PET scan can help to decide the stage of cancer of the food pipe (oesophageal cancer) before treatment.

Before deciding on the most appropriate treatment for cancer of the oesophagus (gullet), it helps the specialist to know the exact extent of the disease. This is called the stage.

This trial was using a type of scan called a PET scan to help stage oesophageal cancer more accurately. The researchers hoped that the scan would help identify people who could possibly be cured with chemotherapy and surgery to remove their cancer. They also wanted to find out how good PET scans are at assessing the response to chemotherapy. The chemotherapy used was a combination of epirubicin, cisplatin and 5FU (ECF). This was a pilot study.

The aims of this trial were to compare

PET scan, endoscopic ultrasound (EUS) and CT scan
To find out if PET scan was better for staging oesophageal cancer
To find out which scan might be better at assessing who would respond to chemotherapy.

Summary of results

The trial team found that a PET scan could not stage oesophageal cancer any more accurately than a CT scan or endoscopic ultrasound (EUS). But a PET scan could be better at assessing the response to chemotherapy than CT scan or EUS.

The trial recruited 15 people. Everybody taking part had a CT scan, EUS and PET scan before chemotherapy. One patient could not continue to take part in the trial because the PET scan and CT scan showed their cancer had spread to their liver. Of the remaining 14 people 13 had cancer that had spread to the lymph nodes.

After 3 cycles of chemotherapy everybody had a CT scan, EUS and PET scan. They had another PET scan 4 weeks after their last chemotherapy treatment.

Out of the 14 people taking part in the trial, 11 went on to have surgery. After surgery when the doctors looked at the tumours, they found that 2 had responded to chemotherapy and 9 had not.

The PET scan had identified both the patients who had responded. But the CT scan and EUS had only identified 1.

For everyone the CT scan and EUS had accurately shown the size of the cancer (T stage) and any spread to lymph nodes. But the PET scan was not as accurate at showing the T stage of everyone’s cancer and had only picked up 7 out of the 13 where the cancer had spread to the lymph nodes.

The researchers concluded that a CT scan and EUS were better at staging oesophageal cancer than a PET scan. But a PET scan was better at showing who had responded to chemotherapy.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) but may not have been published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.