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

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Abstract

Background and Aim: We assessed the feasibility of combined endoscopic ultrasound and computed tomography on response evaluation in patients with esophageal squamous cell carcinoma treated by definitive chemoradiotherapy, and the impact of response on prognosis. Methods: Sixty patients treated by definitive chemoradiotherapy were followed by miniprobe endoscopic ultrasound and computed tomography. The post-treatment esophageal wall thickness was measured by miniprobe endoscopic ultrasound. Metastatic tumors were evaluated by computed tomography. The correlation between post-treatment image findings and prognosis was evaluated. Results: Twenty-four patients (40%) had esophageal stricture after chemoradiotherapy, which limited complete evaluation by endoscopy. Miniprobe successfully penetrated all strictures to measure post-treatment esophageal wall thickness. Both post-treatment esophageal wall thickness <8mm measured by endoscopic ultrasound and no enlargement of metastatic tumor foci on computed tomography predicted good prognosis (P=0.001). Combined evaluation with these two modalities improved survival prediction (P<0.001). Patients who met the above two criteria after chemoradiotherapy had the longest survival compared with those who met only one or none of the criteria. The corresponding median survivals were >30 months, 16.8 months and 7.1 months, respectively (P<0.001). On multivariate analysis, treatment response is the strongest independent prognostic factor (hazard ratio 3.65, P=0.006) regardless of baseline tumor-node-metastasis staging and chemoradiation regimen. Conclusions: 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.

Original languageEnglish
Pages (from-to)463-469
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume30
Issue number3
DOIs
Publication statusPublished - 2015 Mar 1

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Chemoradiotherapy
Tomography
Therapeutics
Esophageal Stenosis
Endoscopy
Esophageal Squamous Cell Carcinoma
Neoplasms
Pathologic Constriction
Multivariate Analysis
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

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title = "Response evaluation with endoscopic ultrasound and computed tomography in esophageal squamous cell carcinoma treated by definitive chemoradiotherapy",
abstract = "Background and Aim: We assessed the feasibility of combined endoscopic ultrasound and computed tomography on response evaluation in patients with esophageal squamous cell carcinoma treated by definitive chemoradiotherapy, and the impact of response on prognosis. Methods: Sixty patients treated by definitive chemoradiotherapy were followed by miniprobe endoscopic ultrasound and computed tomography. The post-treatment esophageal wall thickness was measured by miniprobe endoscopic ultrasound. Metastatic tumors were evaluated by computed tomography. The correlation between post-treatment image findings and prognosis was evaluated. Results: Twenty-four patients (40{\%}) had esophageal stricture after chemoradiotherapy, which limited complete evaluation by endoscopy. Miniprobe successfully penetrated all strictures to measure post-treatment esophageal wall thickness. Both post-treatment esophageal wall thickness <8mm measured by endoscopic ultrasound and no enlargement of metastatic tumor foci on computed tomography predicted good prognosis (P=0.001). Combined evaluation with these two modalities improved survival prediction (P<0.001). Patients who met the above two criteria after chemoradiotherapy had the longest survival compared with those who met only one or none of the criteria. The corresponding median survivals were >30 months, 16.8 months and 7.1 months, respectively (P<0.001). On multivariate analysis, treatment response is the strongest independent prognostic factor (hazard ratio 3.65, P=0.006) regardless of baseline tumor-node-metastasis staging and chemoradiation regimen. Conclusions: 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.",
author = "Wei-Lun Chang and Wang, {Wen Lun} and Ta-Jung Chung and Forn-Chia Lin and Chia-Jui Yen and Wu-Wei Lai and Yang, {Hsiao Bai} and Bor-Shyang Sheu",
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T1 - Response evaluation with endoscopic ultrasound and computed tomography in esophageal squamous cell carcinoma treated by definitive chemoradiotherapy

AU - Chang, Wei-Lun

AU - Wang, Wen Lun

AU - Chung, Ta-Jung

AU - Lin, Forn-Chia

AU - Yen, Chia-Jui

AU - Lai, Wu-Wei

AU - Yang, Hsiao Bai

AU - Sheu, Bor-Shyang

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Background and Aim: We assessed the feasibility of combined endoscopic ultrasound and computed tomography on response evaluation in patients with esophageal squamous cell carcinoma treated by definitive chemoradiotherapy, and the impact of response on prognosis. Methods: Sixty patients treated by definitive chemoradiotherapy were followed by miniprobe endoscopic ultrasound and computed tomography. The post-treatment esophageal wall thickness was measured by miniprobe endoscopic ultrasound. Metastatic tumors were evaluated by computed tomography. The correlation between post-treatment image findings and prognosis was evaluated. Results: Twenty-four patients (40%) had esophageal stricture after chemoradiotherapy, which limited complete evaluation by endoscopy. Miniprobe successfully penetrated all strictures to measure post-treatment esophageal wall thickness. Both post-treatment esophageal wall thickness <8mm measured by endoscopic ultrasound and no enlargement of metastatic tumor foci on computed tomography predicted good prognosis (P=0.001). Combined evaluation with these two modalities improved survival prediction (P<0.001). Patients who met the above two criteria after chemoradiotherapy had the longest survival compared with those who met only one or none of the criteria. The corresponding median survivals were >30 months, 16.8 months and 7.1 months, respectively (P<0.001). On multivariate analysis, treatment response is the strongest independent prognostic factor (hazard ratio 3.65, P=0.006) regardless of baseline tumor-node-metastasis staging and chemoradiation regimen. Conclusions: 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.

AB - Background and Aim: We assessed the feasibility of combined endoscopic ultrasound and computed tomography on response evaluation in patients with esophageal squamous cell carcinoma treated by definitive chemoradiotherapy, and the impact of response on prognosis. Methods: Sixty patients treated by definitive chemoradiotherapy were followed by miniprobe endoscopic ultrasound and computed tomography. The post-treatment esophageal wall thickness was measured by miniprobe endoscopic ultrasound. Metastatic tumors were evaluated by computed tomography. The correlation between post-treatment image findings and prognosis was evaluated. Results: Twenty-four patients (40%) had esophageal stricture after chemoradiotherapy, which limited complete evaluation by endoscopy. Miniprobe successfully penetrated all strictures to measure post-treatment esophageal wall thickness. Both post-treatment esophageal wall thickness <8mm measured by endoscopic ultrasound and no enlargement of metastatic tumor foci on computed tomography predicted good prognosis (P=0.001). Combined evaluation with these two modalities improved survival prediction (P<0.001). Patients who met the above two criteria after chemoradiotherapy had the longest survival compared with those who met only one or none of the criteria. The corresponding median survivals were >30 months, 16.8 months and 7.1 months, respectively (P<0.001). On multivariate analysis, treatment response is the strongest independent prognostic factor (hazard ratio 3.65, P=0.006) regardless of baseline tumor-node-metastasis staging and chemoradiation regimen. Conclusions: 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.

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DO - 10.1111/jgh.12683

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JO - Journal of Gastroenterology and Hepatology (Australia)

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SN - 0815-9319

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