Perfusion CT can predict the response to chemoradiation therapy and survival in esophageal squamous cell carcinoma: initial clinical results.

The ability to predict the response to chemoradiation therapy (CRT) by contrast-enhanced CT would be valuable for managing esophageal squamous cell carcinoma. The purpose of this study was to evaluate the usefulness of Perfusion CT to predict the response to CRT in patients with esophageal squamous cell carcinoma. Thirty-one consecutive patients with esophageal squamous cell carcinoma underwent Perfusion CT before CRT. We retrospectively investigated the correlations between Perfusion parameters and the response to CRT. Clinicopathological markers and blood flow were compared in terms of survival. There were 21 clinical responders and 10 non-responders. Clinical responders showed significantly higher pre-CRT blood flow (P=0.0004), significantly higher pre-CRT blood volume (P=0.03) and a significantly shorter pre-CRT mean transit time (P=0.002) than non-responders. For pre-CRT blood flow, accuracy was 90.3% for detection of clinical responders when the cut-off point was set at 50 ml/100 g/min. Patients with high blood flow tumors survived significantly longer than those with low blood flow tumors (P=0.006). Multivariate analysis identified blood flow as a significant independent prognostic factor (P=0.01). Therefore, Perfusion CT may help to identify patients with advanced esophageal squamous cell carcinoma who will benefit from CRT.