Universität zu Köln

Bollschweiler, Elfriede, Hoelscher, Arnulf H., Schmidt, Matthias and Warnecke-Eberz, Ute (2015). Neoadjuvant treatment for advanced esophageal cancer: response assessment before surgery and how to predict response to chemoradiation before starting treatment. Chin. J. Cancer Res., 27 (3). S. 221 - 231. BEIJING: CHINESE JOURNAL CANCER RESEARCH CO. ISSN 1993-0631

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Abstract

Patients with advanced esophageal cancer (T3-4, N) have a poor prognosis. Chemoradiation or chemotherapy before esophagectomy with adequate lymphadenectomy is the standard treatment for patients with resectable advanced esophageal carcinoma. However, only patients with major histopathologic response (regression to less than 10% of the primary tumor) after preoperative treatment will have a prognostic benefit of preoperative chemoradiation. Using current therapy regimens about 40% to 50% of the patients show major histopathological response. The remaining cohort does not benefit from this neoadjuvant approach but might benefit from earlier surgical resection. Therefore, it is an aim to develop tools for response prediction before starting the treatment and for early response assessment identifying responders. The current review discusses the different imaging techniques and the most recent studies about molecular markers for early response prediction. The results show that [F-18]-fluorodeoxyglucose-positron emission tomography (FDG-PET) has a good sensitivity but the specificity is not robust enough for routine clinical use. Newer positron emission tomography detector technology, the combination of FDG-PET with computed tomography, additional evaluation criteria and standardization of evaluation may improve the predictive value. There exist a great number of retrospective studies using molecular markers for prediction of response. Until now the clinical use is missing. But the results of first prospective studies are promising. A future perspective may be the combination of imaging technics and special molecular markers for individualized therapy. Another aspect is the response assessment after finishing neoadjuvant treatment protocol. The different clinical methods are discussed. The results show that until now no non-invasive method is valid enough to assess complete histopathological response.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnecke-Eberz, Ute UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-402204
DOI:	10.3978/j.issn.1000-9604.2015.04.04
Journal or Publication Title:	Chin. J. Cancer Res.
Volume:	27
Number:	3
Page Range:	S. 221 - 231
Date:	2015
Publisher:	CHINESE JOURNAL CANCER RESEARCH CO
Place of Publication:	BEIJING
ISSN:	1993-0631
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SQUAMOUS-CELL CARCINOMA; POSITRON-EMISSION-TOMOGRAPHY; HISTOPATHOLOGIC RESPONSE; ENDOSCOPIC ULTRASOUND; TUMOR RESPONSE; FDG-PET; PREOPERATIVE CHEMORADIATION; ESOPHAGOGASTRIC JUNCTION; PATHOLOGICAL RESPONSE; METABOLIC-RESPONSE Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40220