Relationship between the expression of HLA-DR antigen and the effectiveness of preoperative hyperthermo-chemo-radiotherapy in oesophageal cancer

Usefulness of positron emission tomography for assessing the response of neoadjuvant chemoradiotherapy in patients with esophageal cancer

BACKGROUND

In this study, we retrospectively assessed the performance of 18-F-fluorodeoxyglucose positron emission tomography (FDG-PET) compared with computed tomography (CT) and esophagography for assessing the response of advanced esophageal squamous cell carcinoma (SCC) to neoadjuvant chemoradiotherapy.

METHODS

We studied 10 patients with thoracic esophageal SCC who received neoadjuvant chemoradiotherapy followed by surgery. Tumor response was assessed by CT, endoscopy, esophagography and FDG-PET before and after neoadjuvant treatment.

RESULTS

Assessment of the rate of decrease in standardized uptake value (SUV) revealed a partial response (more than 50% decrease) in 5 (50%) of the patients, and assessment of length decrease of FDG uptake showed a partial response in 9 (90%) of the patients. Comparison of the histological response and the rate of decrease of various parameters revealed significant associations between histological response and tumor length (P <0.05), SUV after neoadjuvant therapy (P <0.05), and reduction in the extent of FDG uptake (P <0.01). However histological response was not significantly correlated with the rate of reduction of SUV, for both CT and esophagography.

CONCLUSIONS

FDG-PET may be of considerable value for predicting the pathologic response of esophageal SCC to neoadjuvant therapy. Despite assessment of SUV before neoadjuvant therapy, low FDG uptake after therapy and reduction in the extent of FDG uptake may provide a reliable assessment of the response to therapy.

Preoperative hyperthermochemoradiotherapy for esophageal carcinoma

BACKGROUND

In order to acquire an improved prognosis, preoperative hyperthermia combined with chemotherapy and radiotherapy (HCR) has been performed in our department for patients with esophageal carcinoma.

METHODS

The experimental and clinical investigations that have been continuously performed in our department were introduced with regard to the therapeutic effect brought by HCR for carcinoma, chiefly for esophageal carcinoma.

RESULTS

A series of our investigations have demonstrated the excellent anticancer effect of HCR for esophageal carcinoma.

CONCLUSIONS

Preoperative HCR has contributed to improvements in the prognosis of patients with esophageal carcinoma and is expected to make marked progress in the future with further development of anticancer agents and improvements in the hyperthermia devices.