Clinical Usefulness of Endoscopic Ultrasonography for the Evaluation of the Response of Primary Esophageal Carcinoma to Chemoradiotherapy Miwako Arima 1 , Masahiro Tada 1 , Youichi Tanaka 2 1Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan 2Department of Gastrointestinal Surgery, Saitama Cancer Center, Saitama, Japan Keyword: 食道癌 , 化学放射線療法 , 超音波内視鏡 , 効果判定 , RECIST pp.1840-1854
Published Date 2009/11/25
DOI https://doi.org/10.11477/mf.1403101798
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 We examined the clinical usefulness and problems of endoscopic ultrasonography(EUS)for the evaluation of response in 62 patients with primary esophageal carcinoma who received preoperative neoadjuvant therapy(chemoradiotherapy or chemotherapy)and 79 who received definitive therapy(chemoradiotherapy, radiotherapy, or chemotherapy). Tumor thickness was measured in one direction by EUS, and tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors. In patients who received preoperative neoadjuvant therapy, the tumor reduction rate correlated with the histopathological response of tumors and was superior to endoscopic evaluation for identifying patients who responded to treatment. However, because tumor response was evaluated soon after treatment, a grade 3(markedly effective)response was difficult to determine. In patients who received definitive therapy, tumor response was initially evaluated after 2.4 months on average, and the rate of complete response was 32%. At 5.7 months on average the rate of complete response was 53%. A complete response was achieved in many patients who had a reduction rate of 60% and higher in association with restoration of the layered structure. However, it was considered inappropriate to assign a complete response at that time. The recurrence rate was low in patients who were evaluated to have had a complete response on EUS. Our results showed that EUS was more useful than endoscopy for the strict assessment of complete response. Evaluation of the depth of invasion with a high-frequency miniature ultrasound probe was useful in patients undergoing salvage endoscopic mucosal resection.

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