新辅助化疗（NACT）的疗效与食管鳞状细胞癌（OSCC）患者的生存率相关，但基于PET-CT参数的治疗反应的最佳评估方法尚未建立。我们分析了226名在NACT后接受手术前后接受PET-CT的OSCC患者。我们评估了原发肿瘤的SUVmax、代谢性肿瘤体积（MTV）和总病变葡萄糖代谢（TLG），以及NACT前后PET阳性淋巴结的数量，以预测患者的生存率。在逐步分析中，我们将SUVmax、MTV和TLG降低60%、80%和80%定义为区分对NACT响应者和非响应者的最佳截止值。在ROC分析中，TLG降低率是PET-CT参数中预测复发的最佳指标。TLG响应者的预后显著优于非响应者（2年无进展生存率：64.1％vs. 38.5％；P = 0.0001）。TLG降低率（HR 2.58；95％CI 1.16-5.73）和NACT后PET阳性淋巴结数量（HR 1.79；95％CI 1.04-3.08）是显著独立的预后因素。TLG降低是预测预后的最佳指标。术前PET-CT评估原发肿瘤和淋巴结可以准确地分层食管鳞状细胞癌患者的风险。©2023. 作者（们）。

The efficacy of neoadjuvant chemotherapy (NACT) correlates with patient survival in oesophageal squamous cell carcinoma (OSCC), but optimal evaluation of the treatment response based on PET-CT parameters has not been established.We analysed 226 OSCC patients who underwent PET-CT before and after NACT followed by surgery. We assessed SUVmax, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) for the primary tumour and the number of PET-positive lymph nodes before and after NACT to predict patient survival.In a stepwise analysis, we defined 60%, 80%, and 80% as the optimal cut-off values for SUVmax, MTV, and TLG reduction, respectively, to distinguish responders and non-responders to NACT. In the ROC analysis, the TLG reduction rate was the best predictor of recurrence among PET-CT parameters. The TLG responders achieved significantly more favourable prognoses than non-responders (2-year progression-free survival [PFS] rate: 64.1% vs. 38.5%; P = 0.0001). TLG reduction rate (HR 2.58; 95% CI 1.16-5.73) and the number of PET-positive lymph nodes after NACT (HR 1.79; 95% CI 1.04-3.08) were significant independent prognostic factors.TLG reduction is the best predictor of prognosis. Preoperative PET-CT evaluation of both the primary tumour and lymph nodes could accurately stratify risk in OSCC patients.© 2023. The Author(s).