Purpose:
RATIONALE: Imaging procedures, such as fludeoxyglucose F 18 positron emission tomography
(PET) scans, may improve the ability to detect lung and esophageal cancer or their
recurrence.
PURPOSE: Phase II/III trial to study the effectiveness of fludeoxyglucose F 18 PET scans in
measuring response to induction chemotherapy in patients with esophageal and lung cancer
that may be removed by surgery.
Study summary:
OBJECTIVES: I. Determine whether whole body fludeoxyglucose F 18 (F-18
2-fluoro-2-deoxy-D-glucose; FDG) positron emission tomography (PET) can quantitate the
response to induction (preoperative) chemotherapy in patients with esophageal or non-small
cell lung cancer (NSCLC) by correlating changes in PET scan images with surgical staging,
frequency of complete resection, disease-free survival, and overall survival. II. Correlate
PET scan results with the multiple conventional complementary imaging modalities of thoracic
and/or abdominal CT, bone scans, and cranial MRI. III. Evaluate the use of PET scanning to
uncover disease sites undetected by current imaging modalities.
OUTLINE: This is a nonrandomized study. The choice of chemotherapeutic regimen is at the
discretion of the medical oncologist. If the tumor is resectable after treatment with
chemotherapy, the patients undergoes the appropriate resection as defined by the thoracic
surgeon. All patients have positron emission tomography (PET) scans done within 2 weeks
before the first dose of chemotherapy and again about 2-3 weeks after the third or fourth
dose of chemotherapy. Patients are asked to not eat or drink 6 hours before coming into the
hospital for the PET scan. They are administered an injection of a solution of
fluorodeoxyglucose F 18 (FDG) and then undergo a PET scan.
PROJECTED ACCRUAL: An estimated 75 patients (50 lung cancer and 25 esophageal cancer
patients) will be accrued into this protocol over 24-30 months.
Criteria:
DISEASE CHARACTERISTICS: Histologically confirmed esophageal or non-small cell lung
carcinoma Esophageal cancer: Biopsy proven esophageal carcinoma considered acceptable for
curative esophageal resection Lung cancer: Stages IA-IIIB, T(any)N(any)M0 disease without
pleural effusion, which constitutes locally advanced lung cancer Must be candidates for
induction chemotherapy followed by surgical resection
PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 70-100% Life
expectancy: Not specified Hematopoietic: WBC at least 4,000/mm3 Platelet count at least
160,000/mm3 Hepatic: Bilirubin no greater than 1.0 mg/dL Renal: Creatinine no greater than
1.5 mg/dL Creatinine clearance greater than 65 mL/min Other: Not pregnant Adequate
contraception required of all fertile female patients
PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: See Disease
Characteristics Endocrine therapy: Not specified Radiotherapy: Not specified Surgery: No
prior surgical mediastinal staging such as prior mediastinoscopy or Chamberlain procedures
See Disease Characteristics