Response evaluation with endoscopic ultrasound and computed tomography in esophageal squamous cell carcinoma treated by definitive chemoradiotherapy

Chang, Wei; Wang, Wen Lun; Chung, Ta Jung; Lin, Fengyi; Yen, Chia Jui; Lai, Wu‐Wei; Yang, Hsiao Bai; Sheu, Bor Shyang

doi:10.1111/jgh.12683

Cited by 9 publications

(9 citation statements)

References 26 publications

(72 reference statements)

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“…After completion of 36-gray radiotherapy, a EUS exam was conducted to assess the treatment response. [ 11 ] Briefly, the esophageal mucosa and intraluminal lesion were first inspected by general upper gastrointestinal scope. Then, a EUS miniprobe (2.5 mm in diameter) was inserted into esophageal lumen via the working channel to scan the previous tumor area.…”

Section: Methodsmentioning

confidence: 99%

Radiation dose escalation can improve local disease control and survival among esophageal cancer patients with large primary tumor volume receiving definitive chemoradiotherapy

et al. 2020

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Background This study aimed to investigate the correlation between primary tumor volume and cancer failure patterns in esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT) and examine whether increasing radiation dose can improve the outcome. Methods We retrospectively reviewed 124 patients with stage III ESCC treated by definitive CCRT. The primary tumor volume calculated from the radiotherapy planning computed tomography scans was correlated to treatment response, time to disease progression, and overall survival. We further analyzed whether a higher radiation dose correlated with better disease control and patient survival. Results Patients with poor CCRT response had a larger primary tumor volume than those with good response (97.9 vs 64.3 cm 3 , P = 0.032). The optimal cutoff value to predict CCRT response was 55.3 cm 3 . Large primary tumor volume (≥ 55.3 cm 3 ) correlated with shorter time to tumor progression in the esophagus (13.6 vs 48.6 months, P = 0.033) compared with small tumor volume (< 55.3 cm 3 ). For the large esophageal tumors (≥ 55.3 cm 3 ), radiation dose > 60 gray significantly prolonged the time to tumor progression in esophagus (20.3 vs 10.1 months, P = 0.036) and overall survival (12.2 vs 8.0 months, P = 0.030), compared with dose ≤ 60 gray. In contrast, higher radiation dose did not benefit local disease control or overall survival in the small esophageal tumors (< 55.3 cm 3 ). Conclusion Large primary tumor volume correlates with poor local control and overall survival in ESCC treated with definitive CCRT. Radiation dose > 60 gray can improve the outcomes in patients with large primary tumor. Further prospective dose escalation trials are warranted.

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Section: Methodsmentioning

confidence: 99%

Radiation dose escalation can improve local disease control and survival among esophageal cancer patients with large primary tumor volume receiving definitive chemoradiotherapy

et al. 2020

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“…The results indicated that high miR-193a-5p was correlated with a good CCRT response in KYSE170 and KYSE70 cells. ESCC patients who received CCRT treatment were grouped into good or poor CCRT responses according to the criteria described in a previous study [24, 25]. To verify whether miR-193a-5p is a potential biomarker for the CCRT response, five CCRT good response and four CCRT poor response patient RNA samples were used to evaluate miR-193a-5p expression by real-time PCR.…”

Section: Resultsmentioning

confidence: 99%

MiR-193a-5p/ERBB2 act as concurrent chemoradiation therapy response indicator of esophageal squamous cell carcinoma

et al. 2016

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Concurrent chemoradiation therapy (CCRT) is the predominant treatment in esophageal cancer, however resistance to therapy and tumor recurrence are exceedingly common. Elevated ERBB2/Her2 may be at least partially responsible for both the high rates of recurrence and resistance to CCRT. This receptor tyrosine kinase is upregulated in 10–20% of esophageal squamous cell carcinoma (ESCC) tissues, and amplification of ERBB2 has been correlated with poor prognosis in esophageal cancer. Tissues from 131 ESCC patients, along with cell and animal models of the disease were used to probe the underlying mechanisms by which ERBB2 upregulation occurs and causes negative outcomes in ESCC. We found that overexpression of ERBB2 inhibited radiosensitivity in vitro. Furthermore, miR-193a-5p reduced ERBB2 expression by directly targeting the 3′UTR. Increased miR-193a-5p enhanced radiosensitivity and inhibited tumorigenesis in vitro and in vivo. Additionally, low miR-193a-5p expression correlated with poor prognosis in ESCC patients, and ESCC patients with good CCRT response exhibited higher miR-193a-5p expression. Our data suggest that patients with high miR-193a-5p will likely benefit from CCRT treatment alone, however a combination of CCRT with Herceptin may be beneficial for patients with low miR-193a-5p expression.

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“…Multivariate analysis revealed that chemotherapy regimen and RR were strongly related to survival, and this is consistent with the results of previous researches. 19 , 27 A study reported by Chang et al 19 demonstrated that treatment response is the strongest independent prognostic factor of survival. A previous randomized Phase III clinical trial showed that patients with the higher RR had longer survival than those with lower RR, suggesting that RR might closely be related to longer survival.…”

Section: Discussionmentioning

confidence: 99%

“…The chemotherapy regimen greatly affected the CR and RR, which has been proven to be independent prognostic factors for survival. 18 , 19 To our knowledge, the cisplatinum/paclitaxel regimen has never been compared with the cisplatinum/5-FU regimen directly, for patients with locally advanced ESCC who are not receiving curative intended surgery. Therefore, the optimal chemotherapy regimen is debatable.…”

Section: Discussionmentioning

confidence: 99%

Comparison of cisplatinum/paclitaxel with cisplatinum/5-fluorouracil as first-line therapy for nonsurgical locally advanced esophageal squamous cell carcinoma patients

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Wang²,

Wang³

et al. 2016

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BackgroundTo retrospectively evaluate the efficacy and toxicity of definitive concurrent chemoradiotherapy (dCRT) with cisplatinum/paclitaxel versus cisplatinum/5-fluorouracil in patients with locally advanced esophageal squamous cell carcinoma (ESCC) who received nonsurgical treatment.MethodsThis study retrospectively evaluated 202 patients with locally advanced ESCC treated at Shandong Cancer Hospital between January 2009 and December 2013. All the patients initially received dCRT, including platinum and paclitaxel or 5-fluorouracil, with concurrent 1.8 or 2 Gy/fraction radiation (total dose, 54–60 Gy). The patient population was divided into two treatment groups: 105 patients who received the cisplatinum/paclitaxel regimen were allocated to group A, and 97 patients who received the cisplatinum/5-fluorouracil regimen were allocated to group B. We compared the progression-free survival (PFS) and overall survival (OS) by various clinical variables, including prior treatment characteristics, major toxicities (mainly in grade 3 and 4 hematological), and response to dCRT. We used the receiver operating curve analysis to determine the optimal cutoff value of clinical stage and radiation dose. The Kaplan–Meier method was used for survival comparison and Cox regression for multivariate analysis.ResultsMedian PFS and OS in group A were significantly better compared with group B (median PFS, 15.9 versus 13.0 months, P=0.016 and median OS, 33.9 versus 23.1 months, P=0.014, respectively). The 1- and 2-year survival rates of the two groups were 82.9% versus 76.3%, and 61.9% versus 47.6%, respectively. The complete response and response rate were 17.1% versus 7.2% (P=0.032) and 52.4% versus 30.9% (P=0.042) in group A and B, respectively. Meanwhile, group B was associated with a significantly lower rate of grade 3/4 overall toxicity than group A (P=0.039).ConclusionOur data showed that patients with locally advanced ESCC in group A had longer PFS and OS compared with group B. Cisplatinum/paclitaxel can be considered a good candidate chemotherapy regimen for patients with locally advanced ESCC who are being treated with nonsurgical therapy.

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Response evaluation with endoscopic ultrasound and computed tomography in esophageal squamous cell carcinoma treated by definitive chemoradiotherapy

Abstract: Response evaluation by miniprobe endoscopic ultrasound and computed tomography can predict the prognosis of esophageal squamous cell carcinoma patients treated by definitive chemoradiotherapy. Those who were judged as poor responder should receive additional treatment to improve outcome.

Cited by 9 publications

References 26 publications

Radiation dose escalation can improve local disease control and survival among esophageal cancer patients with large primary tumor volume receiving definitive chemoradiotherapy

Radiation dose escalation can improve local disease control and survival among esophageal cancer patients with large primary tumor volume receiving definitive chemoradiotherapy

MiR-193a-5p/ERBB2 act as concurrent chemoradiation therapy response indicator of esophageal squamous cell carcinoma

Comparison of cisplatinum/paclitaxel with cisplatinum/5-fluorouracil as first-line therapy for nonsurgical locally advanced esophageal squamous cell carcinoma patients

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