Combined modalities of magnetic resonance imaging, endoscopy and computed tomography in the evaluation of tumor responses to definitive chemoradiotherapy in esophageal squamous cell carcinoma.
PURPOSE
To explore the value of combined modalities, including anatomical and functional magnetic resonance imaging (MRI), endoscopy and computed tomography (CT), for the assessment of tumor responses to definitive chemoradiotherapy (dCRT) in esophageal squamous cell carcinoma (ESCC).


METHODS
Sixty-seven patients with locally advanced ESCC were enrolled. Tumor response (TR) was assessed two months after the completion of dCRT. Evaluation criteria according to combined modalities, including MRI, endoscopy and CT, were established and compared with traditional criteria based on CT and endoscopy. Progression-free survival (PFS)⩾12months was used as the reference standard, and the accuracy of the two criteria in response assessment was analyzed.


RESULTS
Thirty-seven (55.2%) and 10 (14.9%) patients were considered to exhibit CR, as assessed by combined modalities and the traditional criteria, respectively. Using PFS⩾12months as a surrogate for CR, the sensitivity and specificity of the combined modalities were 82.4% and 88.9%, respectively, compared with 20.6% and 92.6% for the traditional criteria. TR assessed by combined modalities (CR vs. non-CR) was prognostic of PFS in univariate and multivariate analyses (Log-rank, P<0.0001; Cox regression, HR=0.114, 95% CI 0.048-0.272).


CONCLUSIONS
Tumor responses assessed by the combined modalities of MR, endoscopy and CT seemed highly predictive of prognosis after dCRT in ESCC patients.
['Qiu|Bo|B|', 'Wang|DeLing|D|', 'Yang|Hong|H|', 'Xie|WeiHao|W|', 'Liang|Ying|Y|', 'Cai|Peiqiang|P|', 'Chen|ZhaoLin|Z|', 'Liu|MengZhong|M|', 'Fu|JianHua|J|', 'Xie|ChuanMiao|C|', 'Liu|Hui|H|']
D000328:Adult D000368:Aged D002294:Carcinoma, Squamous Cell D059248:Chemoradiotherapy D018572:Disease-Free Survival D004938:Esophageal Neoplasms D000077277:Esophageal Squamous Cell Carcinoma D004945:Esophagoscopy D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D064847:Multimodal Imaging D009367:Neoplasm Staging D011379:Prognosis D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
Magnetic resonance imaging Endoscopy Computed tomography Chemoradiotherapy Esophageal squamous cell carcinoma Response assessment