Evaluation of Neoadjuvant Radiochemotherapy Response (RCT) in Squamous Esophageal Cancer (ESC) and Implications in Therapeutic Conduct

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Evaluation of Neoadjuvant Radiochemotherapy Response (RCT) in Squamous Esophageal Cancer (ESC) and Implications in Therapeutic Conduct

A. Hanna, R. Birla, C. Iosif, M. Boeriu, R. Tomsa, A. Puscasu, S. Constantinoiu
General reports, no. 3, 2015
The multidisciplinary approach in ESC emerged as a result ofefforts to maximize the treatment outcome of this disease.Surgical approach as the only therapeutic option is notalways followed by a good distance survival. A concomitant neoadjuvant radiochemotherapy in ESC may result in afavourable outcome for responding patients, reducing the sizeof the tumor and the degree of lymph node damage increasing resectability and the R0 resection rate, improving prognosis. For non-responding patients or if the disease continues toprogress under RCT therapy, the surgical time is delayed, adverse effects of radiochemotherapy are added and postoperative morbidity and mortality are increased. The imagingmethods for the assessment of response have only limited valueand metabolic response; only FDG-PET manages to comeclose to pathological response. Determining the responsedegree is very important for the establishment of the surgicalconduct: planned or necessity surgery, or non-surgicalpalliative therapy.