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Esophageal cancer: Positron emission tomography does not improve treatment

Deutsches Aerzteblatt International

Patients with cancer of the esophagus--also known as the gullet--are often given chemo- or radiotherapy, with the aim of shrinking the tumor before it is surgically removed. Increasingly positron emission tomography (PET) is being used to monitor the size of the tumor during the treatment. To date, however, no benefit for patients has ensued, as Milly Schröer-Günther and co-authors show in an original article in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2015; 112: 545-52).

PET is an imaging technique that makes a tumor in the esophagus visible without the patient's having to undergo an invasive examination. Especially during treatment cycles in which the tumor is supposed to shrink, it makes sense to check the tumor's response to the treatment--but so far no studies exist to show that PET improves the treatment for the patients. The authors point out that the studies they have analyzed have often investigated only a small number of patients or that their results are biased. Nevertheless, they say, PET carried out early on in treatment does have the potential to identify patients who will not respond to that treatment, and these patients could then be spared continuing treatment with its associated side effects. To reach this point, however, will require randomized controlled trials.

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Schröer-Günther M, Scheibler F, Wolff R, Westwood M, Baumert BG, Lange S: The role of PET and PET-CT scanning in assessing response to neoadjuvant therapy in esophageal carcinoma--a systematic review. Dtsch Arztebl Int 2015; 112: 545-52. DOI: 10.3238/arztebl.2015.0545

http://www.aerzteblatt.de/pdf.asp?id=171654

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