Qiu Bo, Wang DeLing, Yang Hong, Xie WeiHao, Liang Ying, Cai Peiqiang, Chen ZhaoLin, Liu MengZhong, Fu JianHua, Xie ChuanMiao, Liu Hui
State Key Laboratory of Oncology in South China, Guangzhou, PR China; Guangdong Esophageal Cancer Research Institute, Guangzhou, PR China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
State Key Laboratory of Oncology in South China, Guangzhou, PR China; Guangdong Esophageal Cancer Research Institute, Guangzhou, PR China; Department of Medical Imaging, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
Radiother Oncol. 2016 Nov;121(2):239-245. doi: 10.1016/j.radonc.2016.09.017. Epub 2016 Oct 25.
To explore the value of combined modalities, including anatomical and functional magnetic resonance imaging (MRI), endoscopy and computed tomography (CT), for the assessment of tumor responses to definitive chemoradiotherapy (dCRT) in esophageal squamous cell carcinoma (ESCC).
Sixty-seven patients with locally advanced ESCC were enrolled. Tumor response (TR) was assessed two months after the completion of dCRT. Evaluation criteria according to combined modalities, including MRI, endoscopy and CT, were established and compared with traditional criteria based on CT and endoscopy. Progression-free survival (PFS)⩾12months was used as the reference standard, and the accuracy of the two criteria in response assessment was analyzed.
Thirty-seven (55.2%) and 10 (14.9%) patients were considered to exhibit CR, as assessed by combined modalities and the traditional criteria, respectively. Using PFS⩾12months as a surrogate for CR, the sensitivity and specificity of the combined modalities were 82.4% and 88.9%, respectively, compared with 20.6% and 92.6% for the traditional criteria. TR assessed by combined modalities (CR vs. non-CR) was prognostic of PFS in univariate and multivariate analyses (Log-rank, P<0.0001; Cox regression, HR=0.114, 95% CI 0.048-0.272).
Tumor responses assessed by the combined modalities of MR, endoscopy and CT seemed highly predictive of prognosis after dCRT in ESCC patients.
探讨联合应用解剖学和功能磁共振成像（MRI）、内镜及计算机断层扫描（CT）评估食管鳞状细胞癌（ESCC）根治性放化疗（dCRT）后肿瘤反应的价值。
纳入67例局部晚期ESCC患者。在dCRT完成2个月后评估肿瘤反应（TR）。建立基于MRI、内镜及CT的联合评估标准，并与基于CT和内镜的传统标准进行比较。以无进展生存期（PFS）≥12个月作为参考标准，分析两种标准在反应评估中的准确性。
联合评估标准和传统标准评估为完全缓解（CR）的患者分别有37例（55.2%）和10例（14.9%）。以PFS≥12个月作为CR的替代指标，联合评估标准的敏感性和特异性分别为82.4%和88.9%，而传统标准分别为20.6%和92.6%。单因素和多因素分析中，联合评估标准评估的TR（CR与非CR）是PFS的预后因素（对数秩检验，P<0.0001；Cox回归，HR=0.114，95%CI 0.048-0.272）。
MR、内镜及CT联合评估的肿瘤反应似乎对ESCC患者dCRT后的预后具有高度预测性。
