title: Clinical significance of GLUT-1 expression in patients with esophageal cancer treated with concurrent chemoradiotherapy.
abstract: This study aimed to investigate whether glucose transporter-1 (GLUT-1) expression in a pretreatment esophageal cancer biopsy was predictive of clinical outcomes in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CRT). A total of 25 patients with esophageal cancer treated with concurrent CRT were reviewed. Radiotherapy was administered up to total doses of 40-66.6 Gy (median 66.6 Gy) with a single fraction of 1.8-2 Gy. Regarding chemotherapy, cisplatin (80 mg/m(2) on day 1) and 5-fluorouracil (800 mg/m(2) on days 2-6) were used concurrently with radiotherapy, every 3-4 weeks for a total of 1-2 courses. Tissue samples from esophageal carcinoma were obtained from the 25 patients by biopsy prior to concurrent CRT, and a semiquantitative analysis of GLUT-1 expression was performed using immunohistochemical staining. High GLUT-1 expression was observed in 7 of 25 (28%) patients, and GLUT-1 expression was significantly correlated with clinical T stage (p=0.0454), clinical N stage (p=0.0324) and initial response to CRT (p=0.0185). Patients with a high GLUT-1 expression had significantly poorer local control (LC) (5-year LC 28.6%) than those with a low expression (5-year LC 73.4%, p<005). Multivariate analysis revealed that GLUT-1 and the number of chemotherapy courses were independent prognostic factors for LC. Patients with a high GLUT-1 expression had significantly lower recurrence-free survival (RFS) compared to those with a low GLUT-1 expression (p=0.0405). Multivariate analysis revealed that GLUT-1, the number of chemotherapy courses and clinical M stage were independent prognostic factors for RFS. GLUT-1 expression was significantly correlated with clinical T stage, clinical N stage and initial response to concurrent CRT, and was predictive of LC and RFS for patients with esophageal cancer treated with concurrent CRT.
authors.affiliation: Department of Radiology, University of the Ryukyus, Okinawa, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Chiba
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Morioka
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimoji
authors.forename: Nao
authors.initials: N
authors.lastname: Sunagawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Iraha
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nishimaki
authors.forename: Naomi
authors.initials: N
authors.lastname: Yoshimi
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama