“Treat esophageal cancer can more often without surgery’
Photo: UMC Utrecht
Esophageal cancer successful treatment without major surgery: that is in the future increasingly possible thanks to the promotion of research in the UMC Utrecht.
By making use of advanced scanning techniques, the effect of chemotherapy and radiation therapy for the first time accurately mapped. This can in the long term in a third of the patients a surgical removal of the esophagus be prevented.
Every year approximately 2,500 people in the Netherlands, the diagnosis of esophageal cancer. A large portion of them will now receive standard chemotherapy and radiation therapy to the tumor cells as much as possible. Then follows a major surgery in which the esophagus is removed. But research shows that a third of the patients the esophagus no tumor tissue contains more after chemotherapy and radiation therapy.
“We want patients to unnecessarily such a major operation, let undergo,” says researcher Peter van Rossum. “Using new scanning techniques, we can now preview or that surgery is necessary. This can in the near future, overtreatment is to be avoided and get the individual patient a tailor-made treatment.”
Thanks to the scanning techniques can also during the treatment to be investigated whether the chemotherapy and radiation therapy received well. If this is not the case, can that treatment be discontinued and be taken directly to removal of the esophagus. By earlier to stop the treatment, the patient is less physical strain and is fit for major surgery.
Van Rossum did research into the use of various scanning techniques to provide the best prediction. For this purpose, MRI scans and PET scans used.
In a MRI-scan, cross-sections of parts of the body detailed picture with the aid of a very strong magnetic field. When a PET scan is advance a small amount of radioactive sugar into the blood sprayed. The sugar concentrates in the places where the cancer cells sit. On the images of the PET scan are sugars that visible, so cancer cells can be detected.
An MRI scan, it appears in 80 to 90 percent of the cases, a reliable picture of the number of remaining cancer cells after chemotherapy and radiation therapy. When the PET scan is 70 percent.
The study will now – in cooperation with hospitals in Amsterdam, Groningen and Houston (Texas) – a sequel to the findings in a larger group of patients to verify and to see if a combination of these two scans, an even better outcome. The expectation is that with even more certainty it can be established whether the removal of the esophagus actually needed.
A month earlier survey showed that of the AMC in Amsterdam that it is possible to make clear which patients with a compromised esophagus eventually get cancer. On the basis of the genetic structure of the cells in the esophagus can increase the risk of esophageal cancer in the long-term now be predicted.