Abstract
AbstractIn oesophageal cancer (OC) neo‐adjuvant chemoradiotherapy (neoCRT) is used to debulk tumour size prior to surgery, with a complete pathological response (pCR) observed in approximately ∼30% of patients. Presently no predictive quantitative methodology exists which can predict response, in particular a pCR or major response (MR), in patients prior to therapy.Raman and Fourier transform infrared imaging were performed on OC tissue specimens acquired from 50 patients prior to therapy, to develop a computational model linking spectral data to treatment outcome. Modelling sensitivities and specificities above 85% were achieved using this approach. Parallel in‐vitro studies using an isogenic model of radioresistant OC supplied further insight into OC cell spectral response to ionising radiation where a potential spectral biomarker of radioresistance was observed at 977 cm−1.This work demonstrates that chemical imaging may provide an option for triage of patients prior to neoCRT treatment allowing more precise prescription of treatment.
Highlights
Oesophageal cancer (OC) presents a significant therapeutic challenge to cure
In patients who present with locally advanced disease and are considered for treatment with curative intent, current therapeutic regimens focus on neo-adjuvant treatment with chemotherapy alone or neo-adjuvant chemoradiotherapy
Despite the identification of a strong vibration centred at 977 cm−1 in Apo-E4 an ELISA analysis of OE33 P and R cell lysates did not demonstrate expression of this protein
Summary
Oesophageal cancer (OC) presents a significant therapeutic challenge to cure. There are two main disease subtypes: oesophageal adenocarcinoma (OAC; originating in glandular cells) and squamous cell carcinoma (SCC; originating in squamous epithelial cells). Randomised clinical trials (RCTs) have established that these combination treatments significantly improve cure rates compared with surgery alone,.[4,5,6] At this time approximately 30% of patients undergoing neoCRT prior to resection will have no evidence of cancer in the resection specimen, a so-called complete pathological response (pCR). If this response could be predicted prior to treatment such patients may possibly be spared surgery. For patients who are resistant to treatment, and may possibly be harmed by a long delay to surgery, this information may completely alter the treatment pathway
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