Prediction of the tumor response and survival based on computed tomography in esophageal squamous cell carcinoma after trimodality therapy.
Prediction of the tumor response and survival based on computed tomography in esophageal squamous cell carcinoma after trimodality therapy.
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基于计算机断层扫描的食管鳞状细胞癌三联治疗后肿瘤反应和生存的预测。
DOI：
10.1007/s00595-021-02277-7
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发表时间：
2021
期刊：
影响因子：
2.5
通讯作者：
Okada M.
中科院分区：
文献类型：
--
作者：
Hirohata R;Hamai Y;Emi M;Kurokawa T;Yoshikawa T;Ohsawa M;Tadokoro K;Okada M.
目的预测食管鳞状细胞癌（ESCC）新辅助放化疗（NCRT）的疗效和预后具有挑战性。本研究评估了术前计算机断层扫描（CT）分析预测的病理反应和生存的食管鳞癌患者接受trimodalitytherapy.MethodsA共119例cT3或T4食管鳞癌谁接受手术后NCRT在2007年和2019年之间进行了评估。在术前、治疗前和治疗期间用增强CT测量基于CT的参数。这些参数之间的关联和病理反应，以及预后，进行了检查。（p= 0.009），治疗前平均CT值（p= 0.022），术前整体肿瘤体积（WTV，p= 0.003），术前最大横截面（LCS，p= 0.002），ΔLCS（治疗前至术前，p= 0.004），ΔWTV（治疗前至术前，p= 0.012）和Δ平均CT值（治疗前至术前，p= 0.012）的原发性病变与良好的病理反应显着相关。无复发生存期（RFS）和总生存期（OS）的Cox回归分析显示，术前LCS是一个独立的基于CT的预测因子。RFS和OS在术前LCS的最佳截止值显著较高（p= 0.036和p = 0.016，分别）。
PurposePredicting the response to neoadjuvant chemoradiotherapy (NCRT) and the prognosis of esophageal squamous cell carcinoma (ESCC) is challenging. This study evaluated the potential of a preoperative computed tomography (CT) analysis for predicting the pathological response and survival of patients with ESCC who received trimodality therapy.MethodsA total of 119 patients with cT3 or T4 ESCC who underwent surgery following NCRT between 2007 and 2019 were assessed. The CT-based parameters were measured with enhanced CT preoperatively, prior to and during treatment. Associations between these parameters and the pathologic response, as well as the prognosis, were examined.ResultsPretreatment maximum CT value (p= 0.009), pretreatment mean CT value (p= 0.022), preoperative whole tumor volume (WTV,p= 0.003), preoperative largest cross section (LCS,p= 0.002), ΔLCS (pretreatment to preoperative,p= 0.004), ΔWTV (pretreatment to preoperative,p= 0.012), and Δmean CT value (pretreatment to preoperative,p= 0.012) of the primary lesion were significantly associated with a good pathological response. A Cox-regression analysis of recurrence-free survival (RFS) and overall survival (OS) showed that preoperative LCS was an independent CT-based predictor. RFS and OS were significantly higher at the optimal cut-off value of the preoperative LCS (p= 0.036 andp= 0.016, respectively).ConclusionsCT-based parameters are thus considered to be valuable predictors of the tumor response and survival after trimodality therapy for ESCC.