Preoperative Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Cancer Using 18F-FDG PET/CT and DW-MRI: A Prospective Multicenter Study

Borggreve, Alicia S; Goense, Lucas; Rossum, Peter S.N. van; Heethuis, S.E.; Hillegersberg, Richard van; Lagendijk, J J W; Lam, Marnix G. E. H.; Lier, Astrid L.H.M.W. van; Mook, Stella; Ruurda, Jelle P.; Vulpen, Marco van; Voncken, Francine E.M.; Aleman, Berthe M.P.; Bartels‐Rutten, Annemarieke; Ma, Jingfei; Fang, Penny; Musall, Benjamin C.; Lin, Steven H.; Meijer, G.J.

doi:10.1016/j.ijrobp.2019.12.038

Cited by 59 publications

(59 citation statements)

References 43 publications

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“…Thus, integrating other novel predictive factors into the model may further improve its prediction ability. Changes in 18 F-fluorodeoxyglucose PET parameters after neoadjuvant CRT, as well as changes of parameters in diffusion-weighted magnetic resonance imaging have been demonstrated to be of complementary value in the evaluation of pathological response [ 30 ]. The alternations in PET radiomic features during CRT also have shown promising results for prediction of response in EC [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers

Chen

Zhao

et al. 2021

Cancer Res Treat

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Purpose This study aimed to develop a nomogram for predicting pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC) by integrating hematological biomarkers and clinicopathological characteristics. Materials and Methods Between 2003 and 2017, 306 ESCC patients who underwent neoadjuvant CRT followed by esophagectomy were analyzed. Besides clinicopathological factors, hematological parameters before, during, and after CRT were collected. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for pCR. A nomogram model was built and internally validated. Results Absolute lymphocyte count (ALC), lymphocyte to monocyte ratio, albumin, hemoglobin, white blood cell, neutrophil, and platelet count generally declined, whereas neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) increased significantly following neoadjuvant CRT. After surgery, 124 patients (40.5%) achieved a pCR. The pCR group demonstrated significantly more favorable survival than the non-pCR group. On multivariate analysis, significant factors associated with pCR included sex, chemotherapy regimen, post-CRT endoscopic finding, pre-CRT NLR, ALC nadir during CRT, and post-CRT PLR, which were incorporated into the prediction model. The nomogram indicated good accuracy in predicting pCR, with a C-index of 0.75 (95% confidence interval, 0.71 to 0.78). Conclusion Female, chemotherapy regimen of cisplatin/vinorelbine, negative post-CRT endoscopic finding, pre-CRT NLR (≤ 2.1), ALC nadir during CRT (> 0.35×10 9 /L), and post-CRT PLR (≤ 83.0) were significantly associated with pCR in ESCC patients treated with neoadjuvant CRT. A nomogram incorporating hematological biomarkers to predict pCR was developed and internally validated, showing good predictive performance.

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Section: Discussionmentioning

confidence: 99%

Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers

Chen

Zhao

et al. 2021

Cancer Res Treat

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“…However, the NCCN guideline committee recommends endoscopy and biopsy [1]. Others have suggested a role for 18F-FDG PET/CT, diffusion-weighted MRI [39] or molecular biomarkers, such as circulating tumor DNA [40] for response evaluation, which has to be explored in future studies. The potential benefits of such extensive assessments have to outweigh the impact on either patients and healthcare facilities.…”

Section: Discussionmentioning

confidence: 99%

Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer

Vos‐Geelen

Geurts

Nieuwenhuijzen

et al. 2021

European Journal of Surgical Oncology

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Introduction: The aim of this retrospective study was to determine the patterns of recurrence and overall survival (OS) in patients achieving clinical complete response after treatment with definitive chemoradiation (CRT) for proximal esophageal cancer. Materials and methods: Patients with proximal esophageal cancer treated with CRT between 2004 and 2014 in 11 centers in the Netherlands were included. OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Cumulative incidence of first recurrence (locoregional or distant) and locoregional recurrence (LRR) were assessed using competing risk analyses. Results: In 197 of the 200 identified patients, response was evaluated, 133 (68%) showed a complete response. In complete responders, median OS, three-year OS, and PFS were 45.0 months (95% CI 34.8 e61.5 months), 58% (95% CI 48e66), and 49% (95% CI 40e57), respectively. Three-and five-year risk of recurrence were respectively 40% (95% CI 31e48), and 45% (95% CI 36e54). Three-and five-year risk of LRR were 26% (95% CI 19e33), and 30% (95% CI 22e38). Eight of 32 patients with an isolated LRR underwent salvage surgery, with a median OS of 32.0 months (95% CI 6.8-not reached). Conclusion: In patients with a complete response after definitive CRT for proximal esophageal cancer, most recurrences were locoregional and developed within the first three years after CRT. These findings suggest to shorten locoregional follow-up from five to three years.

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“…42 Moreover, there was a study that has already demonstrated MRI and PET-CT might be of complementary value in the assessment of pCR. 43 After neoadjuvant therapy, what the optimal time interval for surgery is remains under investigation. The study implied that it is safe for patients to postpone surgery for at least 7-10 weeks after NCRT.…”

Section: Comparison Between Ncrt and Nctmentioning

confidence: 99%

“…The PRIDE Study is a prospective, single‐arm, observational multicenter study, which will use magnetic resonance imaging (MRI) and 18 F‐fluorodeoxyglucose positron emission tomography with computed tomography ( 18 F‐FDG PET‐CT) to predict response and clinical stage after treatment 42 . Moreover, there was a study that has already demonstrated MRI and PET‐CT might be of complementary value in the assessment of pCR 43 . After neoadjuvant therapy, what the optimal time interval for surgery is remains under investigation.…”

Section: Comparison Between Ncrt and Nctmentioning

confidence: 99%

Optimal preoperative neoadjuvant therapy for resectable locally advanced esophageal squamous cell carcinoma

Leng

Daiko²,

Han

et al. 2020

Annals of the New York Academy of Sciences

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Esophageal squamous cell carcinoma (ESCC) is one of the most common malignancies worldwide, especially in East Asia. ESCC accounts for more than 90% of esophageal cancer. Currently, neoadjuvant therapy in combination with surgical resection is the mainstay of treatment. However, the overall survival rate of patients with locally advanced ESCC is not satisfactory even when treated following the standard treatment guidelines. With neoadjuvant chemoradiotherapy, chemotherapy, or emerging immunotherapy, continuous exploration of efficacy in relation to ESCC is expected to improve overall survival further. Here, we review and summarize current evidence for efficacy of preoperative therapy for locally advanced ESCC.

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Preoperative Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Cancer Using 18F-FDG PET/CT and DW-MRI: A Prospective Multicenter Study

Cited by 59 publications

References 43 publications

Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers

Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers

Patterns of recurrence following definitive chemoradiation for patients with proximal esophageal cancer

Optimal preoperative neoadjuvant therapy for resectable locally advanced esophageal squamous cell carcinoma

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