Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Eur J Surg Oncol. 2011 Dec;37(12):1064-71. doi: 10.1016/j.ejso.2011.09.004. Epub 2011 Sep 22.
Chemoradiotherapy is increasingly applied in patients with oesophageal cancer. The aim of the present study was to determine whether 3D-CT volumetry is able to differentiate between responding and non-responding oesophageal tumours early in the course of neoadjuvant chemoradiotherapy.
Serial CT before and after two weeks of neoadjuvant chemoradiotherapy was performed in the multimodality treatment arm of a randomised trial including patients with oesophageal carcinoma. CT response was measured with the change in tumour volume between baseline and after 14 days of neoadjuvant therapy. Receiver Operating Characteristic (ROC) analysis was used to evaluate the ability of 3D-CT as an early imaging marker of response.
CT response analysis was performed in 39 patients, of whom 26 patients were histopathological responders. Median tumour volume increased between baseline and after 14 days of chemoradiotherapy in histopathological responders as well as in non-responders, though changes were not statistically significant. The area under the ROC curve was 0.71.
Tumour volume changes after 14 days of neoadjuvant chemoradiotherapy as measured by 3D-CT were not associated with histopathological tumour response. CT volumetry should not be used for early response assessment in patients with potentially curable oesophageal cancer treated with neoadjuvant chemoradiotherapy.
化学放疗在食管癌患者中应用越来越广泛。本研究旨在确定在新辅助化疗放疗过程中早期，3D-CT 体积测量是否能够区分反应性和非反应性食管肿瘤。
在一项包括食管癌患者的随机试验的多模式治疗臂中，在新辅助化疗放疗前和两周后进行了连续 CT。通过在新辅助治疗 14 天后基线和肿瘤体积变化来测量 CT 反应。接收者操作特性（ROC）分析用于评估 3D-CT 作为反应早期影像学标志物的能力。
对 39 名患者进行了 CT 反应分析，其中 26 名患者为组织病理学反应者。在组织病理学反应者和非反应者中，基线和新辅助化疗放疗 14 天后的肿瘤体积中位数均增加，尽管变化无统计学意义。ROC 曲线下面积为 0.71。
通过 3D-CT 测量的新辅助化疗放疗 14 天后的肿瘤体积变化与组织病理学肿瘤反应无关。在接受新辅助化疗放疗的潜在可治愈食管癌患者中，CT 体绘制不应用于早期反应评估。
