scholarly journals Predicting Treatment Response to Neoadjuvant Chemoradiotherapy in Rectal Mucinous Adenocarcinoma Using an MRI-Based Radiomics Nomogram

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhihui Li ◽  
Shuai Li ◽  
Shuqin Zang ◽  
Xiaolu Ma ◽  
Fangying Chen ◽  
...  
Keyword(s):  
Treatment Response ◽  
Mucinous Adenocarcinoma ◽  
Tumor Regression ◽  
Neoadjuvant Chemoradiotherapy ◽  
Roc Curves ◽  
Quantitative Mri ◽  
Tumor Regression Grade ◽  
Patient Variables ◽  
Validation Set ◽  
Radiomics Signature

ObjectiveTo build and validate an MRI-based radiomics nomogram to predict the therapeutic response to neoadjuvant chemoradiotherapy (nCRT) in rectal mucinous adenocarcinoma (RMAC).MethodsTotally, 92 individuals with pathologically confirmed RMAC administered surgical resection upon nCRT in two different centers were assessed retrospectively (training set, n = 52, validation set, n = 40). Rectal MRI was performed pre-nCRT. Radiomics parameters were obtained from high-resolution T2-weighted images and selected to construct a radiomics signature. Then, radiomics nomogram construction integrated patient variables and the radiomics signature. The resulting radiomics nomogram was utilized to assess the tumor regression grade (TRG). Diagnostic performance was determined by generating receiver operating characteristic (ROC) curves and decision curve analysis (DCA).ResultsSix optimal features related to TRG were obtained to construct a radiomics signature. The nomogram combining the radiomics signature with age and mucin deposit outperformed the radiomics signature alone in the training (AUC, 0.950 vs 0.843, p < 0.05) and validation (AUC, 0.868 vs 0.719, p < 0.05) cohorts. DCA demonstrated a clinical utility for the radiomics nomogram model.ConclusionsThe established quantitative MRI-based radiomics nomogram is effective in predicting treatment response to neoadjuvant therapy in patients with RMAC.

scholarly journals Evaluating treatment response to neoadjuvant chemoradiotherapy in rectal cancer using various MRI-based radiomics models

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhihui Li ◽  
Xiaolu Ma ◽  
Fu Shen ◽  
Haidi Lu ◽  
Yuwei Xia ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Treatment Response ◽  
Nearest Neighbor ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Principal Component ◽  
Tumor Regression Grade ◽  
K Nearest Neighbor

Abstract Background To validate and compare various MRI-based radiomics models to evaluate treatment response to neoadjuvant chemoradiotherapy (nCRT) of rectal cancer. Methods A total of 80 patients with locally advanced rectal cancer (LARC) who underwent surgical resection after nCRT were enrolled retrospectively. Rectal MR images were scanned pre- and post-nCRT. The radiomics features were extracted from T2-weighted images, then reduced separately by least absolute shrinkage and selection operator (LASSO) and principal component analysis (PCA). Four classifiers of Logistic Regression, Random Forest (RF), Decision Tree and K-nearest neighbor (KNN) models were constructed to assess the tumor regression grade (TRG) and pathologic complete response (pCR), respectively. The diagnostic performances of models were determined with leave-one-out cross-validation by generating receiver operating characteristic curves and decision curve analysis. Results Three features related to the TRG and 11 features related to the pCR were obtained by LASSO. Top five principal components representing a cumulative contribution of 80% to overall features were selected by PCA. For TRG, the area under the curve (AUC) of RF model was 0.943 for LASSO and 0.930 for PCA, higher than other models (P < 0.05 for both). As for pCR, the AUCs of KNN for LASSO and PCA were 0.945 and 0.712, higher than other models (P < 0.05 for both). The DCA showed that LASSO algorithm was clinically superior to PCA. Conclusion MRI-based radiomics models demonstrated good performance for evaluating the treatment response of LARC after nCRT and LASSO algorithm yielded more clinical benefit.

scholarly journals Association between Paclitaxel Clearance and Tumor Response in Patients with Esophageal Cancer

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 173
Author(s):  
Eelke L.A. Toxopeus ◽  
Femke M. de Man ◽  
Nanda Krak ◽  
Katharina Biermann ◽  
Annemieke J.M. Nieuweboer ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Treatment Response ◽  
Tumor Regression ◽  
Geometric Mean ◽  
Neoadjuvant Chemoradiotherapy ◽  
Systemic Exposure ◽  
Tumor Regression Grade ◽  
P Value ◽  
Response To Chemotherapy ◽  
Regression Grade

Inter-individual variability in paclitaxel pharmacokinetics may play a role in the response to chemotherapy. Therefore, we studied the association between paclitaxel clearance and treatment response in patients with esophageal cancer. All patients who received paclitaxel (plus carboplatin) treatment for esophageal cancer between 2007 and 2013 were included. The treatment was given as neoadjuvant chemoradiotherapy (nCRT), induction chemotherapy (iCT), or palliative chemotherapy (pCT). The treatment response was assessed by the tumor regression grade (TRG) or by the RECIST1.1 criteria, respectively. The unbound paclitaxel clearance (CL) was estimated with NONMEM. The log-transformed clearance was related to response with ANOVA and independent sample t-tests. A total of 166 patients were included, of whom 113 received nCRT, 23 iCT and 30 pCT. In patients receiving nCRT, paclitaxel clearance was not associated with tumor regression grade (p-value = 0.25), nor with pathologically complete response (geometric mean 561.6 L/h) and residual disease (geometric mean 566.1 L/h, p-value = 0.90). In patients who underwent iCT or pCT, also no association between paclitaxel clearance and RECIST outcome was identified (iCT: p-value = 0.08 and pCT: p-value = 0.81, respectively). In conclusion, systemic paclitaxel exposure was not associated with response to common paclitaxel-based treatment regimens for esophageal cancer. Future studies should focus on tumor exposure in relation to systemic exposure and treatment outcome.

Rectal cancer – current treatment strategy and the tumor regression grade evaluation after neoadjuvant therapy in patients who underwent surgery at the I. Department of Surgery, General University Hospital in Prague between 2012 and 2016

2021 ◽  
Vol 100 (2) ◽  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Tumor Regression ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Current Treatment ◽  
University Hospital ◽  
Tumor Regression Grade ◽  
Oncological Treatment ◽  
Regression Grade

Introduction: The article contains a summary of the issues of staging and therapy with an emphasis on the neoadjuvant treatment and associated tumor regression grade with the analysis of our own group of patients. Methods: Retrospective analysis of patients with rectal cancer who underwent a surgery at the 1st Department of Surgery – Thoratic, Abdominal and Injury Surgery; First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic, focusing on those who underwent neoadjuvant chemoradiotherapy and their pathologists evaluated tumor regression grade after the resection. Results: The group consists of 161 patients operated on between 2012 and 2016. 47 patients underwent neoadjuvant oncological treatment with further evaluation of the tumor regression grade by a pathologist, a scoring system according to Ryan was used. A complete pathological response was elicited in 10.4% of patients, no response in 35.4% of patients, and partial tumor regression in 54.2%. Conclusion: Although there is a difference in our results compared to foreign publications, the proportion of patients remains comparable. Studies evaluating the advantages versus disadvantages of neoadjuvant therapy will certainly follow, and the question of the suitability of surgical treatment as the only curative solution is partially raised.

scholarly journals Radiomics Nomogram of DCE-MRI for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

2020 ◽  
Vol 10 ◽  
Author(s):  
Ning Mao ◽  
Yi Dai ◽  
Fan Lin ◽  
Heng Ma ◽  
Shaofeng Duan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Roc Curves ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Dce Mri ◽  
Validation Set ◽  
Selection Operator ◽  
Radiomics Signature

PurposeThis study aimed to establish and validate a radiomics nomogram based on dynamic contrast-enhanced (DCE)-MRI for predicting axillary lymph node (ALN) metastasis in breast cancer.MethodThis retrospective study included 296 patients with breast cancer who underwent DCE-MRI examinations between July 2017 and June 2018. A total of 396 radiomics features were extracted from primary tumor. In addition, the least absolute shrinkage and selection operator (LASSO) algorithm was used to select the features. Radiomics signature and independent risk factors were incorporated to build a radiomics nomogram model. Calibration and receiver operator characteristic (ROC) curves were used to confirm the performance of the nomogram in the training and validation sets. The clinical usefulness of the nomogram was evaluated by decision curve analysis (DCA).ResultsThe radiomics signature consisted of three ALN-status-related features, and the nomogram model included the radiomics signature and the MR-reported lymph node (LN) status. The model showed good calibration and discrimination with areas under the ROC curve (AUC) of 0.92 [95% confidence interval (CI), 0.87–0.97] in the training set and 0.90 (95% CI, 0.85–0.95) in the validation set. In the MR-reported LN-negative (cN0) subgroup, the nomogram model also exhibited favorable discriminatory ability (AUC, 0.79; 95% CI, 0.70–0.87). DCA findings indicated that the nomogram model was clinically useful.ConclusionsThe MRI-based radiomics nomogram model could be used to preoperatively predict the ALN metastasis of breast cancer.

scholarly journals Immunohistochemical Markers as Predictors of Histopathologic Response and Prognosis in Rectal Cancer Treated with Preoperative Adjuvant Therapy: State of the Art

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Alessandro Del Gobbo ◽  
Stefano Ferrero
Keyword(s):  
Rectal Cancer ◽  
State Of The Art ◽  
Tumor Regression ◽  
Dihydropyrimidine Dehydrogenase ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Response To Therapy ◽  
Tumor Regression Grade ◽  
Immunohistochemical Markers ◽  
Rectal Cancers

We explain the state of the art of the immunohistochemical markers of response in rectal cancers treated with neoadjuvant medical therapies and its implication with prognosis. Neoadjuvant chemoradiotherapy is widely used to improve the outcome of patients with locally advanced rectal cancer, and the evaluation of the effects of medical therapy is to date based on histomorphological examination by applying four grading systems of response to therapy (tumor regression grade (TRG)). The need to identify immunohistochemical markers that could ensure a better assessment of response and possibly provide additional prognostic information has emerged. We identified p53, p27kip1, Ki67, matrix metalloprotease-9, survivin, Ki67 proliferative index, CD133, COX2, CD44v6, thymidylate synthase, thymidine phosphorylase, and dihydropyrimidine dehydrogenase as the most common markers studied in literature to date, and we explained their prognostic potential and their implications in the evaluation of the response to preoperative therapies in rectal cancers.

The prognostic value of a modified tumor regression grade after neoadjuvant chemoradiotherapy and resection of esophageal carcinoma.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 4066-4066
Author(s):  
Maarten CJ Anderegg ◽  
Sjoerd M Lagarde ◽  
Wernard A Borstlap ◽  
Suzanne S Gisbertz ◽  
Sybren L. Meijer ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Prognostic Value ◽  
Tumor Regression ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumor Regression Grade ◽  
Regression Grade

Serial ctDNA analysis as a real-time indicator of neoadjuvant chemoradiotherapy in rectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3569-3569 ◽  
Author(s):  
Jiaolin Zhou ◽  
Guole Lin ◽  
Yuhua Gong ◽  
Yanyan Zhang ◽  
Yan-Fang Guan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Lymph Node Involvement ◽  
Tumor Regression Grade ◽  
Treatment Intensification

3569 Background: Neoadjuvant chemoradiotherapy (nCRT) is nowadays the standard of care for the locally advanced rectal cancer (LARC). However, there is no effective method to predict patients’ possible benefits from nCRT and monitor the response to it. Methods: Patients with locally advanced middle and low rectal cancer of stage cT3-4N0M0 or cTanyN+M0 were enrolled from August 2017 to July 2018. All patients received nCRT with long-term radiation plus fluorouracil based chemotherapy, followed by the radical surgery. Serial plasma samples were collected pre-nCRT, during nCRT, and preoperatively (8 weeks after the completion of nCRT). Somatic mutations were detected with next-generation sequencing using a 1021-gene panel with peripheral blood lymphocyte DNA as a germline control. Results: This prospective cohort study enrolled 61 patients with rectal cancer. The pathological complete response (pCR) rate and the downstage rate was 31% (19/61) and 80% (49/61), respectively. ctDNA was detectable in 77% (47/61), 18% (11/61) and 13% (8/61) of blood samples obtained pre-nCRT, during nCRT and preoperatively, respectively. No significant association was observed between pre-nCRT ctDNA status with any clinicopathological factors, including age, gender, differentiation or tumor circumferential extent. Among the 8 patients with detectable ctDNA preoperatively, pathological tumor regression grade (TRG) of CAP 2-3 were observed and hepatic metastasis was found in 4 patients within 2 months. For patients with undetectable pre-operative ctDNA, a higher proportion archived pathological downstaging (85% vs 50%). The correlation between preoperative ctDNA status and achievement of pathological downstage was independent of age, gender or differentiation (p = 0.02). In addition, preoperative ctDNA positivity was associated with the persistently involved lymph node (p = 0.02). However, neither pre-nCRT nor during-nCRT ctDNA status was associated with pathological downstaging or persistently lymph node involvement. Conclusions: Detectable ctDNA after the completion of nCRT is a predicator of unsatisfactory curative effect of patients with LARC, which might indicate novel treatment intensification studies. Clinical trial information: NCT03042000.

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