The prognosis of esophageal cancer is poor as most patients present with locally advanced or metastatic disease. The treatment of choice in patients with locally advanced disease (T2-4a/N1-3/M0) is radical surgery with neoadjuvant chemoradiation. Nevertheless, even after neoadjuvant chemoradiation, recurrences occur frequently and complete responses are still relatively low. The response rate of neoadjuvant treatment (41.4 Gy with concurrent carboplatin/paclitaxel) varies between 22%-35%. Another problem is the high rate of recurrences (up to 50%), even after a pathologic complete response (pCR). To gain more insight in the cause of the relatively low response rate and recurrences after pCR, we need to obtain a better understanding of the nature of these tumors and determine better predictive factors. A population of cells the so-called cancer stem-like cells (CSCs) is known to be highly resistant to chemoradiation and therefore targeting these cells might contribute to a better response. With good predictive factors a better choice can be made regarding the potential effect of neoadjuvant treatment as well as surgical resection leading to more personalized therapy. The goal of this research is to identify new predictive factors for the response to neoadjuvant chemoradiation in esophageal cancer and to find therapies to target the CSC population potentially leading to a better response.
|Qualification||Doctor of Philosophy|
|Place of Publication||[Groningen]|
|Publication status||Published - 2017|