|Budget Amount *help
¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 2006: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2005: ¥1,000,000 (Direct Cost: ¥1,000,000)
Esophageal cancer is one of the most dismal diseases with poor prognosis.
Although the standard treatment of esophageal cancer is surgical rejection, a recent advancement of diagnostic and therapeutic procedure leads to a variety of treatment choices other than surgery, such as chemotherapy, radiation, chemoradiotherapy, and the combination of all treatment modalities. Recent reports have indicated that the chemoradiotherapy(CRT) shows almost equal therapeutic effect to surgery, with organ preservation. Thus, the indication of CRT has been widening for an operable esophageal cancer. However, in general, pathological complete response remains around 20〜30% and late adverse effects of CRT are severe. Moreover, salvage surgery after radical CRT with more than 50Gy often results in severe morbidity and mortality. Thus, it is necessary to establish the predictive tcol for a sensitivity of CRT which can guide decision making of treatment strategy for esophageal cancer. In this study, we evaluated the predictive value of gene expression, 3DCT, FDG-PET for chemosensitivity of esophageal cancer.
We clarified the following results from the current study.
1) Positive expression of p21 protein can predict histological CR of esophageal cancer after CRT.
2) FDG-PET can predict the effectiveness of CRT for a primary lesion but for lymph node metastasis.
3) Effectiveness against lymph node is different between intra-and extra-radiation field.
4) The change of SUV max value of PET before and after CRT is not enough to evaluate the sensitivity of chemoradiation.
5) The radiaticn more than 50Gy is more effective than less than 40Gy with regard to MIB-1 index, Tunnel index, and histopai ; hological effect.
6) 3DCT is a valuable means to assess the sensitivity of CRT against esophageal cancer.
At present, several biomarkers or imaging modalities are not enough to be a predictive tool to assess of CRT against esophageal cancer. Further studies are necessary.