title: Oesophageal cancer: assessment of tumour response to chemoradiotherapy with tridimensional CT.
abstract: OBJECTIVE
  To investigate whether changes in tumour volume were predictive of histopathological response to neoadjuvant therapy for oesophageal cancer.
  
  
  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 cm(2) (range 1.79-21.0) and 33.80 cm(3) (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.
authors.affiliation: Department of Surgical Oncology, Veneto Institute of Oncology-IRCCS, Padova, Italy, rita.alfieri@ioveneto.it.
authors.forename: Rita
authors.initials: R
authors.lastname: Alfieri
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pintacuda
authors.forename: Matteo
authors.initials: M
authors.lastname: Cagol
authors.forename: Tommaso
authors.initials: T
authors.lastname: Occhipinti
authors.forename: Ivan
authors.initials: I
authors.lastname: Capraro
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
authors.forename: Gianpietro
authors.initials: G
authors.lastname: Zanchettin
authors.forename: Francesco
authors.initials: F
authors.lastname: Cavallin
authors.forename: Mauro
authors.initials: M
authors.lastname: Michelotto
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.forename: Ermanno
authors.initials: E
authors.lastname: Ancona
authors.forename: Carlo
authors.initials: C
authors.lastname: Castoro
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007558:Italy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019047:Phantoms, Imaging; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden