Establishment of the individual treatment strategy in multidiciplinary therapy for patients with advanced esophageal squamous cell carcinoma

晚期食管鳞癌多学科治疗个体化治疗策略的建立

• 批准号: 14571195
• 负责人: YASUDA Takushi
• 金额: $ 2.62万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14571195/
• 关键词: multidisciplinary therapy; FDG-PET; SUVmax; p53; salvege surgery; histological response; tumor blood flow; perfusion CT; 集学的治療効果予測; SUV; 組織学的効果予測; pathological CR

(1) Prediction of the response to preoperative therapy by p53 status for patients with advanced esophageal squamous cell carcinoma (SCC).The presence or absence of mutation within exon 4 to 9 of p53 gene was analyzed with endoscopic biopsy sample before treatment using SSCP technique. Chemoradiotherapy was received in 67 patients, who were divided in 48 of wild type (WT) and 19 of mutant (MT). Grade 2 or more histological response was obtained in 31 of WT group (65%), to the contrary, in only 2 of MT group (11%). In 30 patients who underwent chemotherapy, WT and MT were observed in 21 and 9 patients, respectively. Clinically good responders were shown in 16 of WT group (76%) and only I of MT group (11%).(2) Response evaluation of neoadjuvant therapy by FDG-PET prediction of histological response.According to post treatment PET analysis, patients with or without FDG accumulation were classified in PET positive or PET negative. The maximum cross-sectional square area of residual tumor ranged from 0 to 32.6mm2 (average 10.0mm2) in PET negative group and from 66.0 to 676.0mm2 (average 287.7mm2) in PET positive group. The histological good response of grade 2 to 3 was obtained in 15 of PET negative patients (88%) and in only 2 of PET positive patients (12%).(3) Positive indication of salvage surgery.The 1-and 3-year overall survival rate were 93.3% and 81.7% in PET negative group compared with 67.8% and 40.7% in PET positive group.Conclusion: In multidisciplinary treatment for advanced esophageal SCC, the analysis of p53 status is useful to predict a treatment resistance and also FDG-PET may be the extremely useful modality to predict a histological response after neoadjuvant therapy. Post-treatment PET negative patient may be a good candidate for salvage surgery.

（1）预测p53状态对晚期食管鳞状细胞癌（SCC）患者的术前治疗的反应。使用SSCP技术治疗前，用内窥镜活检样本对p53基因的外显子4至9进行突变的存在或不存在。 67例患者接受了化学放疗，这些患者被分为48例野生型（WT）和19个突变体（MT）。在WT组的31个（65％）中，仅在MT组的2个（11％）中获得了2级或更多的组织学反应（65％）。在30例接受化学疗法的患者中，分别在21例和9例患者中观察到WT和MT。在WT组的16个（76％）中显示了临床上良好的响应者，仅MT组的I（11％）。（2）通过FDG-PET预测组织学反应对新辅助治疗的响应评估。通过组织学反应的预测，治疗后PET分析，有或没有FDG积累的患者在PET阳性或PET阳性中分类为PET或PET负面。残留肿瘤的最大横截面面积在PET负组中为0至32.6mm2（平均10.0mm2），PET阳性组的最大肿瘤面积为66.0至676.0mm2（平均287.7mm2）。 The histological good response of grade 2 to 3 was obtained in 15 of PET negative patients (88%) and in only 2 of PET positive patients (12%).(3) Positive indication of salvage surgery.The 1-and 3-year overall survival rate were 93.3% and 81.7% in PET negative group compared with 67.8% and 40.7% in PET positive group.Conclusion: In multidisciplinary treatment for advanced esophageal SCC, the analysis of p53 status对于预测耐药性很有用，而FDG-PET也可能是预测新辅助治疗后组织学反应的极为有用的方式。治疗后宠物阴性患者可能是挽救手术的良好候选者。

项目成果

安田卓司, 矢野雅彦, 他: "外科切除成績からみた食道がん治療における化学放射線療法の適応と意義"癌の臨床. 50(2). 111-118 (2004)

Takuji Yasuda、Masahiko Yano 等人：“基于手术切除结果的放化疗治疗食管癌的指征和意义”，Cancer Clinic 50(2) (2004)。

安田卓司, 矢野雅彦, 他: "外科切除成績からみた食道癌治療における化学放射線療法の適応と意義"癌の臨床. (In press).

Takuji Yasuda、Masahiko Yano 等：“从手术切除结果的角度看放化疗治疗食管癌的适应症和意义”《临床癌症》（正在出版）。

Kishi K., Yasuda T., et al.: "Prediction of the response to chemoradiation and prognosis in oesophageal squamous cancer"British Journal of Surgery. 89.

Kishi K.、Yasuda T.等人：“食管鳞癌放化疗反应和预后的预测”英国外科杂志。

Kishi K., Yasuda T., et al.: "Prediction of the response to chemoradiation and prognosis in oesophageal squamous cancer."British Journal of Surgery. 89. 597-603 (2002)

Kishi K.、Yasuda T. 等人：“食管鳞癌放化疗反应和预后的预测。”英国外科杂志。