Zhang Andu,Han Jing,Shi Gaofeng,Han Chun,Wang Lan,Wang Yanfei,Zhang Jun,Tian Hua,Kong Jie,Zhang Jian.The application of MRI in predicting therapeutic effect and prognosis of chemoradiotherapy for esophageal cancer[J].Chinese Journal of Radiological Medicine and Protection,2016,36(11):822-826
The application of MRI in predicting therapeutic effect and prognosis of chemoradiotherapy for esophageal cancer
Received:May 17, 2016  
DOI:10.3760/cma.j.issn.0254-5098.2016.11.005
KeyWords:Esophageal Neoplasms  Chemoradiotherapy  Diffusion-weighted imaging  Apparent-diffusion coefficient
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Author NameAffiliationE-mail
Zhang Andu Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Han Jing Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Shi Gaofeng Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China gaofengs62@sina.com 
Han Chun Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Wang Lan Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Wang Yanfei Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Zhang Jun Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Tian Hua Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Kong Jie Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
Zhang Jian Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China  
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Abstract::
      Objective To explore magnetic resonance diffusion-weighted imaging (MR-DWI) apparent diffusion coefficient(ADC) value in predicting therapeutic effect and prognosis of chemoradiotherapy for esophageal cancer. Methods 100 cases of patients with esophageal carcinoma were enrolled from March 2010 to September 2013 prospectively, MR-DWI was performed before and after CRT. Kaplan-Meier and Logrank methods were used to calculate the overall survival, and Cox regression model was used for multivariate prognostic analysis. Results The ADC value of CR group was higher than that of the PR group both before and after radiotherapy(z=-3.010, -3.689, P<0.05). The 1, 3, 5-year survival rate of the low-ADC value group (≤1.60×10-3mm2/s) and the high-group (>1.60×10-3mm2/s) of tumor before radiotherapy were 58.2%, 21.9%, 10.9% and 73.3%, 50.6%, 39.2% respectively(χ2=9.879, P<0.05). The 1, 3, 5-year survival rate of the low-ADC value group (≤ 2.50×10-3mm2/s) and the high-group (>2.50×10-3mm2/s) after radiotherapy were 52.2%, 23.6%, 14.2% and 75.9%, 44.1%, 32.4% respectively(χ2=5.455, P<0.05). Both low-ADC value group and high-ADC value group before radiotherapy were divided into 4 groups according to ΔADC, the OS of the high-ADC value group before radiotherapy which had a higher ΔADC was the best, and the low-ADC value group before radiotherapy which had a lower ΔADC was the worst. The OS of the other two groups had an interaction (χ2=13.096, P<0.05). Multivariate analysis indicated that the pre-CRT ADC group was an independent prognostic factor for OS. Conclusions MR-DWI ADC value could predict therapeutic effect and prognosis in esophageal carcinoma.Trial registration Chinese clinical trial registry, ChiCTR-PNC-16009484
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