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Apparent diffusion coefficient values detected by diffusion-weighted imaging in the prognosis of patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiation

Authors Liu S, Zhen F, Sun N, Chen J, Cao Y, Zhang S, Cheng H, Ge X, Sun X

Received 29 February 2016

Accepted for publication 6 July 2016

Published 21 September 2016 Volume 2016:9 Pages 5791—5796

DOI https://doi.org/10.2147/OTT.S107466

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 3

Editor who approved publication: Professor Min Li


Shu Liu,1,* Fuxi Zhen,2,* Nana Sun,3 Jiayan Chen,1 Yuandong Cao,1 Sheng Zhang,1 Hongyan Cheng,4 Xiaolin Ge,1 Xinchen Sun1

1Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 3Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Department of General Internal Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Purpose: Previous studies have demonstrated that apparent diffusion coefficient (ADC) values measured by magnetic resonance imaging have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). However, the role of ADC needs to be validated in a cohort of Chinese ESCC patients. This study assessed the role of ADC in predicting the outcome of patients with ESCC treated only by chemoradiation in the People’s Republic of China.
Patients and methods: Seventy-three patients with local advanced ESCC were retrospectively analyzed in this study; none of the patients underwent surgery before or after chemoradiation. The ADC values of the primary tumors were determined by magnetic resonance imaging. The ADC values were then correlated with clinicopathological and other radiological parameters. Survival analysis was carried out to determine if ADC had an impact on survival of these patients.
Results: The median ADC value of the esophageal cancer tissue was 1.256*10-3 mm2/sec (range: 0.657–2.354*10-3 mm2/sec, interquartile range 0.606*10-3 mm2/sec). No clinicopathological or radiological parameters were associated with the ADC values except the sites of tumor tissues. ADC <1.076*10-3 mm2/sec predicted significantly worse survival in patients with ESCC (12.9 months vs undefined, P=0.0108).
Conclusion: The ADC value is a potent prognostic factor which can be used to predict the outcome of patients with ESCC treated only by chemoradiation.

Keywords: esophageal cancer, radiation, prognosis, ADC, chemotherapy, diffusion-weighted MRI

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