MRI evaluation of the neoadjuvant chemoradiation therapy result in a patient with rectal cancer, supplemented with T2-WI texture analysis of the tumor: a clinical case

The article presents a clinical case of using the active follow-up strategy (the so-called watch wait) in a 73-year-old patient with cancer of the lower rectum with a good response to neoadjuvant chemoradiation therapy (NCRT). After 3 years of regular follow-up, including digital rectal examination, rectoscopy and MRI, indicating the absence of tumor progression, PET/ CT with 18F-FDG was obtained, which revealed a region of hypermetabolic activity in the lower rectum (SUVmax 27.1), in connection with which it was decided to carry out surgical treatment. When discussing the issue of the volume of the operation, MRI data were taken into account, supplemented by the results of T2-weighted texture analysis, which confirmed the absence of progression. The patient underwent organ-preserving treatment in the amount of transanal tumor resection. Pathomorphological examination after surgery established the inflammatory changes in the intestinal wall and absence of tumor. This case demonstrates the effectiveness of the standard examination volume when using the watch wait strategy and the possibility of using T2-WI texture analysis to increase the reliability of MRI assessment of tumor response to chemotherapy.

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Evaluation of the efficiency of neoadjuvant chemoradiation therapy for colorectal cancer on the basis of texture analysis of T2-weighted MR images

Onkologiya Zhurnal imeni P A Gertsena ◽

10.17116/onkolog20198041243 ◽

2019 ◽

Vol 8 (4) ◽

pp. 243

Author(s):

T. P. Berezovskaya ◽

Ya. A. Dayneko ◽

A. A. Nevolskikh ◽

S. A. Ivanov ◽

A. D. Kaprin

Keyword(s):

Colorectal Cancer ◽

Texture Analysis ◽

Neoadjuvant Chemoradiation ◽

Chemoradiation Therapy ◽

Mr Images ◽

Neoadjuvant Chemoradiation Therapy

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Effects of Neoadjuvant Chemio-Radiation Therapy on the Anal Sphincter Function in Patients with Low Rectal Cancers

Creative Surgery and Oncology ◽

10.24060/2076-3093-2020-10-3-190-197 ◽

2020 ◽

Vol 10 (3) ◽

pp. 190-197

Author(s):

A. B. Baichorov ◽

A. O. Rasulov

Keyword(s):

Anal Sphincter ◽

Neoadjuvant Chemoradiotherapy ◽

Functional Results ◽

Neoadjuvant Chemoradiation ◽

Chemoradiation Therapy ◽

Preoperative Treatment ◽

Neoadjuvant Chemoradiation Therapy ◽

Reconstruction Methods ◽

Anterior Rectal Resection ◽

Significant Difference

The aim of the study was to compare functional results prior to and following neoadjuvant chemoradiation therapy.Materials and methods. An analysis of the functional results of a prospective clinical study was carried out. The study included 90 patients who underwent low anterior rectal resection for cancer of the lower or middle ampullar rectum with T1-4aN0-2M0 using various reconstruction methods.Results and discussion. Group A included 22 patients with J-shaped reservoirs; group B — 30 patients with side-to-end anastomoses; group C — 38 patients with end-to-end anastomoses. Out of the total study group (n = 90), 43 patients underwent neoadjuvant chemoradiotherapy vs. 47 patients without any preoperative treatment. No statistically significant difference was observed in the frequency of applied reconstructive techniques (р = 0.725) and the incidence of postoperative complications (p = 0.103) in the groups with and without neoadjuvant chemoradiotherapy. The baseline scores of the Wexner scale and the results of anorectal manometry in the comparison groups were comparable (p > 0.05). However, upon completion of neoadjuvant chemoradiotherapy and during the period from the moment of surgery up to 12 months after the closure of preventive intestinal stomas, the functional results were less satisfactory in the group of patients having received neoadjuvant chemoradiotherapy (n = 43) with regard to the comparison group (n = 47). Nevertheless, a statistically significant difference in the results was observed from the end of neoadjuvant chemoradiotherapy up to 3 months after closure of the stoma (p <0.05).Conclusions. Neoadjuvant chemoradiation therapy has a negative effect on the function of the anal sphincter, thus requiring concomitant therapy and physiotherapy both at the stages of neoadjuvant chemoradiotherapy and at long intervals after the main surgical stage.

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