Esophagogastric Junction Cancer, Esophagus Cancer
Conditions
Brief summary
Magnetic resonance imaging (MRI) with functional features of diffusion weighted imaging (DWI) are advancing imaging technologies that have potential to overcome limitations of conventional staging methods, radiation treatment planning and the assessment of tumor response in esophageal or esophagogastric cancer. This study aimed to explore the value of MRI for the prediction of tumor response to chemoradiotherapy and accurate target volume delineation as compared to CT simulation for patients with unresectable or potentially resectable esophageal or esophagogastric cancer undergoing chemoradiotherapy. The average CT texture features are also extracted before and during treatment to establish a model to predict the prognosis or side effects (e.g. radiation pneumonitis or esophagitis) of patients.
Detailed description
1. Both DW-MRI and CT simulation will be performed before chemoradiotherapy and after 18-22 fractions. Also MRI will be performed after treatment. The investigators will contour based on the MRI image and compare this with the standard CT plan before and during treatment. 2. The predictive potential of initial tumor ADC, and change in ADC during and after treatment for tumor response will be assessed. 3. The average CT texture features not only in the present study but also of those who treated previously in our department (since 2014) will be extracted before and during chemoradiotherapy to establish a model to predict the prognosis of patients.
Interventions
Sponsors
Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically confirmed squamous cell carcinoma, adenocarcinoma of the esophageal or esophagogastric junction * Unresectable or potentially resectable tumor (cT3-4N0-1M0-M1a, according to AJCC 6th) based on standard primary staging by EUS and CT * Age\>18 years * No distant metastasis other than supraclavicular lymph nodes * No prior history of thoracic radiation or chemotherapy * Patients must have normal organ and marrow function as defined below: Leukocytes: greater than or equal to 3,500 G/L; Platelets: greater than or equal to 100,000/mm3 .Hemoglobin:greater than or equal to 10g/L .Total bilirubin: within normal institutional limits; AST/ALT: less than or equal to 1.5 times the upper limit; Creatinine within normal upper limits * Informed consent
Exclusion criteria
* Contraindication for MRI scanning * Patients with other cancer history except cervical carcinoma in situ and non-malignant melanoma skin cancer * Pregnant or lactating females * Contraindication for radiotherapy or chemotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Tumor response based on MRI and CT simulation | up to 8 weeks | — |
| Radiotherapy target volume assessment with pre- and post-chemoradiotherapy based on MRI and CT simulation | up to 8 weeks | — |
| Evaluation of tumor heterogeneity with IBEX software | up to 8 weeks | Using the average CT images for texture extraction. Histogram, gradient, cooccurrence, gray-tone difference, and filtration-based techniques are used for texture feature extraction. Models incorporating texture features are established to compare to models incorporating clinical prognostic factors alone. |
Secondary
| Measure | Time frame |
|---|---|
| Overall survival | 1 year |
| Progress free survival | 1 year |
| Reduction in acute and late side effects based on modified RT treatment volumes with pre- and post-chemoradiotherapy based on MRI and CT simulation | 1 year |
Countries
China
Contacts
Primary ContactXin Wang, MD
Outcome results
None listed