scholarly journals Predicting treatment response to neoadjuvant chemoradiotherapy in local advanced rectal cancer by biopsy digital pathology image features

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Fang Zhang ◽  
Su Yao ◽  
Zhi Li ◽  
Changhong Liang ◽  
Ke Zhao ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Treatment Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Digital Pathology ◽  
Advanced Rectal Cancer ◽  
Image Features ◽  
Local Advanced ◽  
Pathology Image

scholarly journals BMI May Be a Prognostic Factor for Local Advanced Rectal Cancer Patients Treated with Long-Term Neoadjuvant Chemoradiotherapy

2020 ◽  
Vol Volume 12 ◽  
pp. 10321-10332
Author(s):  
Hengchang Liu ◽  
Ran Wei ◽  
Chunxiang Li ◽  
Zhixun Zhao ◽  
Xu Guan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Local Advanced

scholarly journals The predictive value of baseline volumetric PET/CT parameters on treatment response and prognosis in locally-advanced rectal cancer treated with neoadjuvant chemoradiotherapy

2021 ◽  
Author(s):  
Abdullah SAKİN ◽  
Suleyman Sahin ◽  
Sevda Saglampınar Karyagar ◽  
Savas Karyagar ◽  
Muhammed Mustafa atci ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Cells ◽  
Treatment Response ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Group I ◽  
Pet Ct ◽  
Group Ii

Abstract Purpose:To investigate the prognostic effects of baseline volumetric PET/CT parameters including the maximum standard uptake value(SUVmax), metabolic tumor volume(MTV), and tumor lesion glycolysis(TLG) on treatment response and prognosis in locally-advanced rectal cancer(LARC) treated with neoadjuvant chemoradiotherapy(NACRT).Methods:Between 2015 and 2018, 51 patients with LARC treated with NACRT followed by surgery were included in this retrospective study. Patients were divided into 2 groups by tumor regression grade(TRG) as follows;Group I=TRG 1(No detectable cancer cells)+TRG 2(single cells and/or small groups of cancer cells) and Group II=TRG3(residual tumor outgrown by fibrosis)+TRG 4(remarkable fibrosis outgrown by tumor cells)+TRG 5(No fibrosis with extensive residual cancer).Results:Of the 51 patients, 34(66.7%) were male. The median age was 55(range,37-78) years. According to TRG status, 14(27.4%) patients were in group I and 37(72.6%) patients were in group II. The area under the curve(95% CI) was 0.749(0.593-0.905) in the ROC curve plotted for MTV. The cut of value for MTV was 12, with 70% sensitivity and 65% specificity. MTV was≥12 in 32(62.8%) patients. MTV and TLG values were significantly different between Group I and II, whereas there was no significant difference between the groups in terms of SUVmax values (p=0.006, p=0.033, and p=0.673, respectively). The disease-free survival was not reached in patients with MTV<12 vs. 20 months in those with MTV≥12 (p=0.323). In multivariate analysis, MTV(OR, 95% Cl, 5.00[1.17-21.383]) was found to be the factor that affected pathological complete response.Conclusion:In LARC treated with NACRT, MTV prior to treatment can help predict the response to treatment.

scholarly journals Fractal-Based Radiomic Approach to Tailor the Chemotherapy Treatment in Rectal Cancer: A Generating Hypothesis Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Carmela Di Dio ◽  
Giuditta Chiloiro ◽  
Davide Cusumano ◽  
Francesco Catucci ◽  
Luca Boldrini ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Staging ◽  
Univariate Analysis ◽  
External Validation ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Logistic Models ◽  
Advanced Rectal Cancer ◽  
Image Features

IntroductionThe aim of this study was to create a radiomic model able to calculate the probability of 5-year disease-free survival (5yDFS) when oxaliplatin (OXA) is or not administered in patients with locally advanced rectal cancer (LARC) and treated with neoadjuvant chemoradiotherapy (nCRT), allowing physicians to choose the best chemotherapy (CT) regimen.MethodsLARC patients with cT3–4 cN0 or cT1–4 cN1–2 were treated according to an nCRT protocol that included concomitant CT schedules with or without OXA and radiotherapy dose of 55 Gy in 25 fractions. Radiomic analysis was performed on the T2-weighted (T2-w) MR images acquired during the initial tumor staging. Statistical analysis was performed separately for the cohort of patients treated with and without OXA. The ability of every single radiomic feature in predicting 5yDFS as a univariate analysis was assessed using the Wilcoxon–Mann–Whitney (WMW) test or t-test. Two logistic models (one for each cohort) were calculated, and their performance was assessed using the area under the receiver operating characteristic (ROC) curve (AUC).ResultsA total of 176 image features belonging to four families (morphological, statistical, textural, and fractal) were calculated for each patient. At the univariate analysis, the only feature showing significance in predicting 5yDFS was the maximum fractal dimension of the subpopulation identified considering 30% and 50% as threshold levels (maxFD30–50). Once the models were developed using this feature, an AUC of 0.67 (0.57–0.77) and 0.75 (0.56–0.95) was obtained for patients treated with and without OXA, respectively. A maxFD30–50 &gt;1.6 was correlated to a higher 5yDFS probability in patients treated with OXA.ConclusionThis study suggests that radiomic analysis of MR T2-w images can be used to define the optimal concomitant CT regimen for stage III LARC cancer patients. In particular, by providing an indication of the gross tumor volume (GTV) spatial heterogeneity at initial staging, maxFD30–50 seems to be able to predict the probability of 5yDFS. New studies including a larger cohort of patients and external validation sets are recommended to verify the results of this hypothesis-generating study.

scholarly journals IMMUNOHISTOCHEMICAL AND GENETIC PROGNOSTIC FACTORS OF NEOADJUVANT CHEMORADIOTHERAPY EFFICАCY IN PERSONALIZED TREATMENT OF LOCAL ADVANCED RECTAL CANCER

2020 ◽  
Vol 73 (3) ◽  
pp. 589-596
Author(s):  
Vitalii V. Zvirych ◽  
Yuriy I. Michailovich ◽  
Oleksandr І. Gorbach ◽  
Natalia М. Khranovska
Keyword(s):  
Rectal Cancer ◽  
Protein Expression ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Expression Level ◽  
Protein Expression Level ◽  
Ki 67 ◽  
Mthfr Polymorphism ◽  
Tumour Relapse ◽  
Local Advanced

The aim: The aim of our study was to define the factors that can robustly predict a response to neoadjuvant chemoradiotherapy (NCRT) in patients with local advanced rectal cancer (LARC) and prognosis factors of progression free survival (PFS) using molecular (8-oxodGu), immunohystochemical (Ki-67) and genetic (GSTP1 and MTHFR genes polymorphism) markers. Materials and methods: GSTP1 and MTHFR polymorphisms were studied by real-time PCR on tumour material from 110 patients with LARC. Ki-67 protein expression was assessed using rabbit monoclonal antibodies to Ki-67 (Dako, Denmark) on EnVisionTM FLEX detection system (Dako, Denmark). 8-oxodGu level in eluate was measured by spectrophotometry. Results: Patients from both groups showed significant pathomorphological response to NCRT. It is robust correlation between 8-oxodGu levels in patients’ blood and their response to CRT (mrTRG scale) in MG was determined. Oxaliplatin-containing chemotherapy promotes statistically significant decrease of 8-oxodGu levels. With the decrease of Ki-67 protein expression level the probability of tumour relapse increases. It is determined that critical value of Ki-67 protein expression level makes less than 27 and tumour relapse probability in this case makes 50%. Tumour relapse risk in patients with GSTP1 and MTHFR polymorphism is 12.3 and 16.3 times higher than in patients who do not carry such polymorphism, respectively. Combination of GSTP1, МTНFR polymorphisms and Кі-67 protein expression factors determines prognostic probability of tumour relapse within 51-99%. Conclusions: 8-oxodGu level can serve as independent prognostic factor of NCRT efficacy in patients with LARC. Combination of GSTP1, МTНFR genes polymorphism with Кі-67 protein expression decrease enables monitoring and robust prognosis of LARC relapse.

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