Marinus, Annejet Willemijn (2025) Clinical parameters predicting complete tumor response following neoadjuvant chemoradiation therapy in patients with esophageal cancer. thesis, Medicine.
Full text available on request.Abstract
Background: For patients with locally advanced EC, nCRT followed by surgery remains one of the preferred curative treatments, as established by the CROSS trial. However, esophagectomy is associated with significant morbidity and reduced quality of life. The aim of this study is to identify clinical parameters predicting complete tumor response. Identifying patients with higher chances of complete tumor response may guide more individualized, organ-preserving treatment strategies. Method: Patients with localized EC (cT1N1 or cT2–4aN0–3), treated with nCRT at the UMCG between 2014 and 2024 were included. Patients either underwent surgery within six months, entered active surveillance protocol following cCR at restaging with a 12 months follow-up period, or were diagnosed with metastasized EC at restaging or peri-operatively. Patient-, tumor- and treatment-related factors were analyzed. A multivariable logistic regression model was built, model performance was assessed using ROC-AUC, and finally a nomogram was developed to visualize the variables and their respective impact on complete tumor response. Results: Among 471 included patients, SCC, IB-IIA/B tumor stage, low TV, PRT, and higher BMI were each independently associated with complete tumor response. Conclusion: This study identified histology, clinical tumor stage, TV, radiotherapy technique, and BMI as independent predictors of complete tumor response after nCRT in patients with EC. These findings may help guide patient selection for active surveillance. However, external validation is needed before clinical implementation.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Etten, Boudewijn van and Muijs, Kristel and Frederiks, Mark |
| Faculty: | Medical Sciences |
| Date Deposited: | 10 Apr 2026 13:37 |
| Last Modified: | 10 Apr 2026 13:37 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3918 |
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