Tumor Volume Reduction Assessed by Planning Computed Tomography in Patients with Rectal Cancer during Preoperative Chemoradiation: Impact of Residual Tumor Volume on the Prediction of Pathologic Tumor Regression

Objective To assess the efficacy and safety of Flutamide (androgen receptor blocker) as an adjuvant therapy for presurgical tumor volume reduction in cases of Juvenile Nasopharyngeal Angiofibroma (JNA). Methods Therapeutic trial, Janurary-December 2007. 10 previously untreated cases of JNA (Radkowski stage IIC-IIIB) were administered Flutamide (10 mg/kg in 3 divided doses) for 6 weeks prior to surgical excision. Pre- and post-therapy tumor volume assessment undertaken by MR Imaging. All cases had periodic liver function tests and assessment of primary and secondary sexual characteristics continuing till 6 months post-therapy. Results Pre-pubertal cases had inconsistent and minimal responses to Flutamide. All 7 post-pubertal cases (as indicated by age and serum testosterone levels) however, demonstrated consistent tumor volume reduction ranging from 6% to 35% (mean 16.6 %). Two cases with optic nerve compression had significant improvements in visual acuity and visual fields. No adverse effect was noted excepting for mild and transient breast tenderness. Conclusions Preoperative use of Flutamide is safe and leads to partial tumor regression in post-pubertal patients. The regression of the tumor away from adjacent vital structures may facilitate surgical excision and limit complications.

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Regression Analysis of Rectal Cancer and Possible Application of Artificial Intelligence (AI) Utilization in Radiotherapy

Applied Sciences ◽

10.3390/app12020725 ◽

2022 ◽

Vol 12 (2) ◽

pp. 725

Author(s):

Majdi Alnowami ◽

Fouad Abolaban ◽

Hussam Hijazi ◽

Andrew Nisbet

Keyword(s):

Artificial Intelligence ◽

Rectal Cancer ◽

Tumor Volume ◽

Reduction Rate ◽

Volume Reduction ◽

Radiation Therapy Treatment Planning ◽

Treatment Volume ◽

Tumor Volume Reduction ◽

Number Of Treatment ◽

Dose Per Fraction

Artificial Intelligence (AI) has been widely employed in the medical field in recent years in such areas as image segmentation, medical image registration, and computer-aided detection. This study explores one application of using AI in adaptive radiation therapy treatment planning by predicting the tumor volume reduction rate (TVRR). Cone beam computed tomography (CBCT) scans of twenty rectal cancer patients were collected to observe the change in tumor volume over the course of a standard five-week radiotherapy treatment. In addition to treatment volume, patient data including patient age, gender, weight, number of treatment fractions, and dose per fraction were also collected. Application of a stepwise regression model showed that age, dose per fraction and weight were the best predictors for tumor volume reduction rate.

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Tumor Volume Reduction Rate Measured by Magnetic Resonance Volumetry Correlated With Pathologic Tumor Response of Preoperative Chemoradiotherapy for Rectal Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2009.07.1682 ◽

2010 ◽

Vol 78 (1) ◽

pp. 164-171 ◽

Cited By ~ 61

Author(s):

Seung-Gu Yeo ◽

Dae Yong Kim ◽

Tae Hyun Kim ◽

Kyung Hae Jung ◽

Yong Sang Hong ◽

...

Keyword(s):

Rectal Cancer ◽

Magnetic Resonance ◽

Tumor Volume ◽

Tumor Response ◽

Reduction Rate ◽

Preoperative Chemoradiotherapy ◽

Volume Reduction ◽

Magnetic Resonance Volumetry ◽

Tumor Volume Reduction

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Effect of oxaliplatin-containing neoadjuvant chemotherapy on tumor volume in locally advanced rectal cancer and sensitivity of surviving tumor cells to radiotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.3547 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 3547-3547 ◽

Cited By ~ 4

Author(s):

Kjersti Flatmark ◽

Knut Hakon Hole ◽

Marie Gron Saelen ◽

Torveig Weum Abrahamsen ◽

Karianne Giller Fleten ◽

...

Keyword(s):

Rectal Cancer ◽

Tumor Volume ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Advanced Rectal Cancer ◽

Locally Advanced Rectal Cancer ◽

Volume Reduction ◽

Median Volume ◽

Tumor Volume Reduction ◽

Additional Tumor

3547 Background: The use of oxaliplatin (OXA) is well established in adjuvant and palliative treatment of colorectal cancer (CRC), but its role in neoadjuvant treatment of locally advanced rectal cancer (LARC) is controversial. Data from the ACCORD 12/0405, STAR-01 and NSABBP R-04 trials suggest no additional clinical benefit of adding OXA to fluoropyrimidine-based preoperative chemoradiotherapy (CRT) in LARC. However, the possibility of reducing risk of systemic recurrence and the use of OXA-containing neoadjuvant chemotherapy (NACT) in liver metastasis warrant further clarification of the role of OXA in neoadjuvant treatment of LARC. Methods: We report results from a non-randomized phase II trial of neoadjuvant treatment of 72 LARC patients, receiving two courses of the Nordic FLOX regimen prior to CRT (25 x 2 Gy; weekly OXA; daily capecitabine). Tumor volumes were calculated from MRI scans taken before and after NACT and 4 weeks after CRT completion. Using OXA resistant human CRC cell lines, the impact of previous OXA exposure on radiosensitivity (1-5 Gy) was examined. Results: Median baseline tumor volume was 16.6 cm3 (1.1-293 cm3). All tumors, except one, responded to NACT, leaving a median tumor volume of 5.3 cm3 (0.2-157 cm3), representing a median volume reduction of 63%. In all but three patients, additional tumor volume reduction was observed following subsequent CRT (median tumor volume 5.3 cm3; 0.02-119 cm3; median volume reduction of 68%). Exposure of cell lines to increasing concentrations of OXA resulted in resistance towards the drug. OXA resistant models exhibited increased radiosensitivity compared to OXA sensitive counterparts. Conclusions: OXA-containing NACT led to substantial tumor volume reduction. Additional tumor volume reduction was observed in almost all cases, suggesting that pretreatment with OXA-containing NACT did not preclude tumor response to CRT. Results from experimental models rather suggest that pretreatment with OXA might enhance radiosensitivity of surviving OXA resistant cells. Taken together, our results are in favor of continued exploration of OXA-containing NACT in LARC. Clinical trial information: NCT00278694.

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