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Oesophageal cancer: assessment of tumour response to chemoradiotherapy with tridimensional CT

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Abstract

Purpose

To investigate whether changes in tumour volume were predictive of histopathological response to neoadjuvant therapy for oesophageal cancer.

Materials and methods

Thirty-five consecutive patients with locally advanced oesophageal cancer were treated with chemoradiotherapy and surgery in responders from July 2007 to July 2009. Tumour volume (TV) was calculated using innovative tumour volume estimation software which analysed computed tomography (CT) data. Tumour diameter and area were also evaluated. Variations in tumour measurements following neoadjuvant treatment were compared with the histopathological data.

Results

Median baseline tumour diameter, area and volume were 3.51 cm (range 1.67–6.61), 7.51 cm2 (range 1.79–21.0) and 33.80 cm3 (range 3.36–101.6), respectively. Differences in TV between the pre- and post-treatment values were significantly correlated with the pathological stage (τ = 0.357, p = 0.004) and the tumour regression grade index (τ = 0.368, p = 0.005). According to the receiver operating characteristic analysis, TV measurements following treatment had moderate predictive values for the pathological T stage (area under the curve, AUC = 0.742, sensitivity = 55.56 %, specificity = 92.86 %, p = 0.005).Comparison of pathological and radiological volume showed a good precision (Pearson rho 0.77).

Conclusions

Changes in TV calculated on CT scans have a limited role in predicting pathological response to neoadjuvant treatment in oesophageal cancer patients. New imaging techniques based on metabolic imaging may provide better results.

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Acknowledgments

The authors are extremely grateful to Dr. Andrea Bulzacchi, Oncological Radiologist, Veneto Oncology Institute, for his precious contribute to the present study. This study was supported in part by a research grant from Ministry of Health, Italy.

Conflict of interest

Rita Alfieri, Tommaso Occhipinti, Giovanna Pintacuda, Ivan Capraro, Marco Scarpa, Carlo Castoro, Alberto Ruol, Matteo Cagol, Gianpietro Zanchettin, Francesco Cavallin, Mauro Michelotto, Luciano Giacomelli and Ermanno Ancona have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgical Oncology, Veneto Institute of Oncology-IRCCS, Padova, Italy

    Rita Alfieri, Matteo Cagol, Marco Scarpa, Francesco Cavallin, Ermanno Ancona & Carlo Castoro

  2. Oncological Radiology, Veneto Institute of Oncology-IRCCS, Padova, Italy

    Giovanna Pintacuda

  3. Veneto Institute of Oncology-IRCCS, Padova, Italy

    Tommaso Occhipinti

  4. Department of Engineering, University of Padova, Padova, Italy

    Ivan Capraro

  5. Department of Surgical and Gastroenterological Sciences, Clinica Chirurgica 1 University of Padova, Padova, Italy

    Gianpietro Zanchettin

  6. Department of Medicine, Surgical Pathology, University of Padova, Padova, Italy

    Mauro Michelotto & Luciano Giacomelli

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  1. Rita Alfieri
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  2. Giovanna Pintacuda
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Correspondence to Rita Alfieri.

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Alfieri, R., Pintacuda, G., Cagol, M. et al. Oesophageal cancer: assessment of tumour response to chemoradiotherapy with tridimensional CT. Radiol med 120, 430–439 (2015). https://doi.org/10.1007/s11547-014-0466-0

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  • DOI: https://doi.org/10.1007/s11547-014-0466-0

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