Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial.
Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial.
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DOI：
10.7150/jca.11738
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发表时间：
2015
影响因子：
3.9
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Xiao J;Cai Z;Li W;Yang Z;Gong J;Huang Y;Deng Y;Wu X;Wang L;Peng J;Ren D;Lan P;Wang J
目的：目的评价三维感兴趣区（3D-ROI）磁共振（MR）容积法测量肿瘤体积缩小率（TVRR）预测局部进展期直肠癌（LARC）术前单纯化疗的病理肿瘤反应。方法：从前瞻性随机试验中招募仅接受新辅助化疗的LARC患者。采用3D-ROI MR体积测定法测量肿瘤体积。使用公式TVRR =（VPre-Therapy - VPost-Therapy）/ VPre-Therapy × 100%确定TVRR。分析TVRR与临床或病理特征的相关性以及TVRR对肿瘤消退分级（TRG）、T降级、N降级和总体降级的病理学肿瘤反应的预测价值。结果：80例LARC患者的TVRR为（51.7±25.1）%。高分化肿瘤的TVRR高于低分化肿瘤（P=0.040）。TVRR与TRG（P<0.001）、T分期（P<0.001）和总分期（P<0.001）有关。当TVRR每增加10%时，达到TRG 2/3的风险降低至57.5%（P=0.002），达到总体前期的几率增加至179.3%（P<0.001）。以TVRR为65%的截断值构建ROC曲线预测TRG的敏感性为0.704，特异性为0.804。结论：在术前单纯化疗的LARC患者中，TVRR与TRG和总降级显著相关，对预测良好的TRG和总降级具有重要价值，具有良好的敏感性和特异性。它可以被认为是一个有前途的候选参数的疗效评价。
Purpose: To evaluate tumor volume reduction rate (TVRR) measured by three-dimensional region-of-interest (3D-ROI) magnetic resonance (MR) volumetry in predicting pathological tumor response of preoperative chemotherapy alone for locally advanced rectal cancer (LARC). Methods: LARC patients who received neoadjuvant chemotherapy only from a prospective and randomized trial were recruited. Tumor volumes were measured with 3D-ROI MR volumetry. TVRR was determined using the equation TVRR = (VPre-Therapy - VPost-Therapy) / VPre-Therapy ×100%. Correlation between TVRR and clinical or pathological characteristics and predictive value of TVRR for pathological tumor response in terms of Tumor Regression Grade (TRG), T downstage, N downstage and overall downstage were analyzed. Results: 80 eligible cases of LARC were included in our study with TVRR of (51.7±25.1) %. TVRR was higher in well-differentiated tumors compared with poor-differentiated tumors (P=0.040). TVRR was found to be related with TRG (P<0.001), T downstage (P<0.001) and overall downstage (P<0.001). Risk of achieving TRG 2/3 decreased to 57.5% (P=0.002) and odds of achieving overall downstage increase to 179.3% (P<0.001) when TVRR increased by every 10%. A sensitivity of 0.704 and specificity of 0.804 were calculated when ROC curve was constructed to predict TRG using TVRR with a cutoff of 65%. Conclusion: TVRR is correlated with TRG and overall downstage significantly in LARC patients treated with preoperative chemotherapy alone and shows great value in predicting favorable TRG and overall downstage with good sensitivity and specificity. It could be considered as a promising parameter candidate for efficacy evaluation.
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影响因子：
5.1
作者：
Chen, Wanqing;Zheng, Rongshou;He, Jie
通讯作者：
He, Jie
影响因子：
158.5
作者：
Kapiteijn, E;Marijnen, CAM;van de Velde, CJH
通讯作者：
van de Velde, CJH
影响因子：
45.3
作者：
Schrag, Deborah;Weiser, Martin R.;Saltz, Leonard B.
通讯作者：
Saltz, Leonard B.
影响因子：
3.9
作者：
Kuo, LJ;Chern, MC;Fang, WT
通讯作者：
Fang, WT
DOI：
10.1016/j.ijrobp.2009.12.055
发表时间：
2011-03-15
影响因子：
7
作者：
Yang, Shih-Neng;Liao, Chih-Ying;Lin, Fang-Jen
通讯作者：
Lin, Fang-Jen