Clinical and Pathologic Evaluation of the Effectiveness of Neoadjuvant Chemoradiation Therapy in Advanced Esophageal Cancer Patients

Akutsu, Yasunori; Matsubara, Hisahiro; Shuto, Kiyohiko; Uesato, Masaya; Mori, Mikito; Hoshino, Isamu; Shiratori, Toru; Miyazawa, Yasumasa; Ito, Hisao; Umemura, Takashi

doi:10.1007/s00268-008-9899-8

Cited by 35 publications

(26 citation statements)

References 26 publications

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“…Furthermore, patients who had a CR, PR, or SD showed a longer PFS (MST: 120 days) compared to cases with PD (MST: 40 days) (p = 0.001). This indicates that patients whose tumors were well controlled tended to have longer PFS and possibly OS than patients whose tumors did not respond to the S-1 monotherapy, and these tendencies are similar to those in patients treated with chemoradiotherapy [12]. …”

Section: Discussionmentioning

confidence: 92%

S-1 Monotherapy as Second- or Third-Line Chemotherapy for Unresectable and Recurrent Esophageal Squamous Cell Carcinoma

et al. 2013

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Purpose: S-1 is widely used for various cancers. It may be useful for esophageal squamous cell carcinoma (ESCC); however, there are insufficient data. The purpose is to provide results of an analysis of S-1 monotherapy for unresectable and recurrent ESCC. Patients and Methods: Twenty patients with histologically proven ESCC who were previously treated with other chemo(radio)therapies were treated with S-1 alone as second- or third-line chemotherapy. Results: A complete response (CR) was observed in 1 case (5%). A partial response (PR), stable disease (SD), and progressive disease (PD) were seen in 4 (20.0%), 7 (35.0%), and 8 (40.0%) cases, respectively. Two cases (10%) of anemia, 1 case (5%) of leukopenia, 3 cases (15%) of fatigue, and 3 cases (15%) of diarrhea were observed as grade 3 toxicity; however, there were no cases of grade 4 toxicity. The 1-year progression-free survival (PFS) rate was 10.0%, and the median PFS was 100 days. The 1-year overall survival (OS) was 30.5%, and the median OS was 330 days. The 1-year PFS rate in CR/PR/SD and PD was 16.7 and 0%, and the median survival time was 120 and 40 days. Conclusion: S-1 is a promising new drug which can be used as a second- or third-line chemotherapy for ESCC.

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Section: Discussionmentioning

confidence: 92%

S-1 Monotherapy as Second- or Third-Line Chemotherapy for Unresectable and Recurrent Esophageal Squamous Cell Carcinoma

et al. 2013

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“…Although a significant survival difference for different histopathological response was detected in survival analysis, the category standard of histopathological response would influence the trial results, for instance <5% residual tumor cells (Akutsu et al, 2009). …”

Section: Discussionmentioning

confidence: 95%

“…Chemoradiation-induced changes histologically included reactive changes such as necrosis, fibrosis, foamy histiocytes, and giant cell reactions. Due to lack of ability to demonstrate any viable and proliferative (nonnecrotic) tumor cells within the specimen, histopathologic responses were determined by dividing the viable residual tumor area by the total tumor area, which was the sum of the areas categorized under the tumor zone according to the published guideline (Becker et al, 2003;Chang et al, 2008;Akutsu et al, 2009;Tong et al, 2010). In case of a diagnostic uncertainty, pathologists reviewed the specimen on a double-headed microscope and immunohistochemical analysis for pancytokeratin was performed.…”

Section: Analysis and Assessment Of Histopathological Responsementioning

confidence: 99%

“…A 2-tiered classification of Tumor Regression Grading based on the literature (Becker et al, 2003;Chang et al, 2008;Akutsu et al, 2009;Tong et al, 2010) was adopted: complete responder (CR), 0-1% residual tumor; noncomplete responder (non-CR), >1% residual tumor. CR was defined as the absence of residual tumor, and fibrosis, mucin lakes, necrotic areas, or keratin flakes extending through the different layers of the esophageal wall.…”

Section: Analysis and Assessment Of Histopathological Responsementioning

confidence: 99%

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Prognostic Significance of 18F-fluorodeoxyglucose Positron Emission Tomography (PET)-based Parameters in Neoadjuvant Chemoradiation Treatment of Esophageal Carcinoma

Chen²,

Song³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Aims and Background: The purpose of the research was to study the prognostic value of tumor 18F-FDG PET-based parameters in neoadjuvant chemoradiation for patients with squamous esophageal carcinoma. Methods: Sixty patients received chemoradiation therapy followed by esophagectomy and two 18FDG-PET examinations at pre-and post-radiation therapy. PET-based metabolic-response parameters were calculated based on histopathologic response. Linear regression correlation and Cox proportional hazards models were used to determine prognostic value of all PET-based parameters with reference to overall survival. Results: Sensitivity (88.2%) and specificity (

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“…This strategy requires the development and availability of novel feasible biomarkers for predicting the sensitivity to chemotherapy and/or radiotherapy. We previously reported that good pathological effectiveness of CRT in the primary tumor was closely associated with good outcome [22] . However, at present, the rate of response to neoadjuvant CRT is unsatisfactory [23] .…”

Section: Discussionmentioning

confidence: 99%

ZNF750 Expression as a Novel Candidate Biomarker of Chemoradiosensitivity in Esophageal Squamous Cell Carcinoma

et al. 2017

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Objective: ZNF750, an epidermal differentiation regulator, has been suggested to act as a tumor suppressor of esophageal squamous cell carcinoma (ESCC). Although a correlation between the epidermal differentiation gene and resistance to chemoradiotherapy (CRT) has been posited, no data regarding the ZNF750 status in ESCC have been reported. The aim of the present study was to evaluate the relationship between ZNF750 expression and response to CRT in ESCC. Methods: Eighty-seven patients who had been pathologically diagnosed with ESCC were evaluated in the present study. All patients underwent neoadjuvant CRT, followed by curative esophagectomy. The expression of ZNF750 in pretreatment biopsy samples was immunohistochemically investigated and compared to the histopathological effectiveness of CRT in surgical specimens. Results: High expression of ZNF750 was closely correlated with good sensitivity to CRT (p = 0.016). A univariate analysis showed that high/intermediate expression of ZNF750 was a significant predictive factor for good sensitivity to CRT (p = 0.006). High/intermediate expression of ZNF750 (30% or more) remained an independent predictive factor for sensitivity to CRT in a multivariate analysis (p = 0.033). Conclusions: ZNF750 expression predicts sensitivity to CRT and can be a biomarker that reliably predicts the response of ESCC to CRT.

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Clinical and Pathologic Evaluation of the Effectiveness of Neoadjuvant Chemoradiation Therapy in Advanced Esophageal Cancer Patients

Abstract: The clinical evaluation for CRT does not reflect the pathologic effectiveness and, even if clinical CR was achieved, viable cancer cells were still present at the primary site in the majority of the population.

Cited by 35 publications

References 26 publications

S-1 Monotherapy as Second- or Third-Line Chemotherapy for Unresectable and Recurrent Esophageal Squamous Cell Carcinoma

S-1 Monotherapy as Second- or Third-Line Chemotherapy for Unresectable and Recurrent Esophageal Squamous Cell Carcinoma

Prognostic Significance of 18F-fluorodeoxyglucose Positron Emission Tomography (PET)-based Parameters in Neoadjuvant Chemoradiation Treatment of Esophageal Carcinoma

ZNF750 Expression as a Novel Candidate Biomarker of Chemoradiosensitivity in Esophageal Squamous Cell Carcinoma

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