Predicting the effects of chemoradiotherapy for squamous cell carcinoma of the esophagus by induction chemotherapy response assessed by positron emission tomography: Toward PET-response-guided selection of chemoradiotherapy or esophagectomy

Ryu Ishihara, Sachiko Yamamoto, Hiroyasu Iishi, Kengo Nagai, Fumi Matui, Natsuko Kawada, Takashi Ohta, Hiromitsu Kanzaki, Masao Hanafusa, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Naotoshi Sugimoto, Yoshifumi Kawaguchi, Kinji Nishiyama, Masaaki Motoori, Masahiko Yano, Takuya Hosoki

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11 Citations (Scopus)

Abstract

Background We have developed a treatment protocol for esophageal cancer involving a single course of induction chemotherapy followed by chemoradiotherapy. This study aimed to determine if it was possible to predict the effects of chemoradiotherapy on the basis of the response to induction chemotherapy, assessed by positron emission tomography (PET). Methods Sixteen patients with Stage II-IVA esophageal cancer were treated using this protocol from April 2007 to July 2010. Chemotherapy involved a fluorouracil and platinum-based combination regimen. All patients received PET scans before and 12-24 days after the beginning of induction chemotherapy. Associations between the response to induction chemotherapy assessed by PET and the effects of chemoradiotherapy were evaluated. Results Induction chemotherapy followed by chemoradiotherapy resulted in complete response (CR) in 10 of the 16 patients. The reduction in maximum standardized uptake value (SUVmax) was 58 ± 12% in patients with CR (n = 10), compared with 14 ± 16% in patients without CR (n = 6) (P < 0.0001). Using a cut-off value of 55% for SUVmax reduction rate, eight of 10 cancers with CR and six of six cancers without CR were correctly identified, providing a sensitivity and specificity of 80 and 100%, respectively. The overall 1-year survival rates for patients with an SUVmax reduction rate >55% (responders) were 100%, compared with 60% for patients with an SUVmax reduction rate ≤55% (non-responders), respectively. Conclusions The response to a single course of induction therapy assessed by PET was significantly associated with the effects of chemoradiotherapy.

Original languageEnglish
Pages (from-to)225-232
Number of pages8
JournalInternational Journal of Clinical Oncology
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 2012

Keywords

  • Chemoradiotherapy
  • Complete response
  • Esophageal cancer
  • Positron emission tomography
  • Squamous-cell type

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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    Ishihara, R., Yamamoto, S., Iishi, H., Nagai, K., Matui, F., Kawada, N., Ohta, T., Kanzaki, H., Hanafusa, M., Hanaoka, N., Takeuchi, Y., Higashino, K., Uedo, N., Sugimoto, N., Kawaguchi, Y., Nishiyama, K., Motoori, M., Yano, M., & Hosoki, T. (2012). Predicting the effects of chemoradiotherapy for squamous cell carcinoma of the esophagus by induction chemotherapy response assessed by positron emission tomography: Toward PET-response-guided selection of chemoradiotherapy or esophagectomy. International Journal of Clinical Oncology, 17(3), 225-232. https://doi.org/10.1007/s10147-011-0278-3