New Perspectives on Predictive Biomarkers of Tumor Response and Their Clinical Application in Preoperative Chemoradiation Therapy for Rectal Cancer

Abstract Background Locally recurrent rectal cancer (LRRC) remains a major problem after curative resection of primary rectal cancer. A noninvasive, prognostic biomarker with which to accurately evaluate disease status and assess the treatment response is critically needed to optimize treatment plans. This study assesses the effectiveness of PET/CT evaluation of preoperative chemoradiation therapy (CRT) in patients with LRRC. Methods Since 2004, we have been performing preoperative CRT to improve local tumor control and survival. Between 2004 and 2013, 40 patients with LRRC underwent preoperative CRT (radiation: 50 Gy/25 fractions; chemotherapy: irinotecan plus UFT [tegafur and uracil]/leucovorin) and radical surgery, and underwent 18F-FDG-PET/CT before and 3 weeks after the completion of CRT. The maximum standardized uptake values (SUVmax) of the pre-CRT scan (Pre-SUV) and the post-CRT scan (Post-SUV) were measured. The predictive value of the 18F-FDG-PET and CT/MRI response assessments was evaluated. Results The mean Pre-SUV was significantly higher than the Post-SUV (8.2 ± 6.1, vs. 3.8 ± 4.0; P < 0.0001). Following CRT, 17/40 patients (42.5%) were classified as responders according to the Mandard tumor regression grade (TRG1–2). The mean Post-SUV was significantly lower in responders than in nonresponders (2.0 ± 1.7 vs. 5.1 ± 3.9; P = 0.0038). Pathological response was not correlated with the response as evaluated by CT (P > 0.9999) or MRI (P > 0.9999). Multivariate regression analysis identified Post-SUV as an independent predictor of local re-recurrence-free survival (P = 0.0383) and for overall survival (P = 0.0195). Conclusions PET/CT is useful in assessing tumor response to preoperative CRT for LRRC and predicting prognosis after surgery.

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Comparison of 2 Preoperative Chemoradiation Therapy Regimens for Locally-Advanced Rectal Cancer: Short-term Tumor Response and Long-term Clinical Outcome of Capecitabine With or Without Irinotecan

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2013.06.870 ◽

2013 ◽

Vol 87 (2) ◽

pp. S330

Author(s):

S. Lee

Keyword(s):

Rectal Cancer ◽

Tumor Response ◽

Locally Advanced ◽

Advanced Rectal Cancer ◽

Locally Advanced Rectal Cancer ◽

Preoperative Chemoradiation ◽

Chemoradiation Therapy ◽

Short Term ◽

Preoperative Chemoradiation Therapy

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Abstract 2694: DNA copy number aberrant profiles predict complete pathologic tumor response to preoperative chemoradiation therapy in locally advanced rectal cancer

10.1158/1538-7445.am10-2694 ◽

2010 ◽

Author(s):

Zhenbin Chen ◽

Zheng liu ◽

Xiwei Wu ◽

Wenyan Li ◽

Julio Garcia-Aguilar

Keyword(s):

Rectal Cancer ◽

Copy Number ◽

Tumor Response ◽

Locally Advanced ◽

Advanced Rectal Cancer ◽

Locally Advanced Rectal Cancer ◽

Preoperative Chemoradiation ◽

Chemoradiation Therapy ◽

Dna Copy Number ◽

Preoperative Chemoradiation Therapy

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The Efficiency of 18F-FDG-PET/CT in Assessment of Tumor Response to Preoperative Chemoradiation Therapy for Locally Recurrent Rectal Cancer

10.21203/rs.3.rs-318397/v1 ◽

2021 ◽

Author(s):

Mamoru Uemura ◽

Masataka Ikeda ◽

Rio Handa ◽

Katsuki Danno ◽

Junichi Nishimura ◽

...

Keyword(s):

Rectal Cancer ◽

Fdg Pet ◽

Tumor Response ◽

Preoperative Chemoradiation ◽

Chemoradiation Therapy ◽

Pet Ct ◽

Preoperative Chemoradiation Therapy ◽

The Mean ◽

Locally Recurrent ◽

Fdg Pet Ct

Abstract Background:Locally recurrent rectal cancer (LRRC) remains a major problem after curative resection of primary rectal cancer. A noninvasive biomarker that accurately evaluates the disease status and assesses the treatment response with prognostic value is critically needed to optimize the treatment plan. This study assesses the effectiveness of PET/CT evaluation of preoperative chemoradiation therapy (CRT) in patients with LRRC.Patients and Methods:Since 2004, we have been performing preoperative CRT to improve local tumor control and survival. Between 2004 and 2013, 40 patients with LRRC underwent preoperative CRT (radiation; 50 Gy/25 fractions, chemotherapy; irinotecan plus UFT/leucovorin ) and radical surgery, and underwent 18F-FDG-PET/CT before and 3 weeks after the completion of CRT. The maximum standardized uptake value (SUVmax) of the pre-CRT scan (Pre-SUV) and the post-CRT scan (Post-SUV) were measured. The predictive ability of 18F-FDG-PET and CT/MRI response assessment were evaluated.Results:The mean Pre-SUV was significantly higher than Post-SUV (8.2±6.1, vs 3.8±4.0; P < 0.0001). Following CRT, 17/40 patients (42.5%) were classified as responders according to Mandard tumor regression grade (TRG1-2). The mean Post-SUV was significantly lower in responders than in nonresponders (2.0±1.7 vs 5.1±3.9; P = 0.0038). Pathological response was not correlated with the response as evaluated by CT (P > 0.9999) or MRI (P > 0.9999). Multivariate regression analysis identified Post-SUV as an independent predictor of local re-recurrence-free survival (P = 0.0383) and for overall survival (P = 0.0195). Conclusions:PET/CT is useful in assessing tumor response to preoperative CRT for LRRC and predicting prognosis after surgery.

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