Early regression index (ERI) on MR images as response predictor in esophageal cancer treated with neoadjuvant chemo-radiotherapy: Interim analysis of the prospective ESCAPE trial.

Autor: Fiorino C; Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy. Electronic address: fiorino.claudio@hsr.it., Palumbo D; Radiology, IRCCS San Raffaele Hospital, Milano, Italy., Mori M; Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy., Palazzo G; Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy., Pellegrini AE; Radiology, IRCCS San Raffaele Hospital, Milano, Italy., Albarello L; Pathology, IRCCS San Raffaele Hospital, Milano, Italy., Belardo A; Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy., Canevari C; Nuclear Medicine, IRCCS San Raffaele Hospital, Milano, Italy., Cossu A; Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy., Damascelli A; Radiology, IRCCS San Raffaele Hospital, Milano, Italy., Elmore U; Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy., Mazza E; Oncology, IRCCS San Raffaele Hospital, Milano, Italy., Pavarini M; Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy., Passoni P; Radiotherapy, IRCCS San Raffaele Hospital, Milano, Italy., Puccetti F; Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy., Slim N; Radiotherapy, IRCCS San Raffaele Hospital, Milano, Italy., Steidler S; Radiology, IRCCS San Raffaele Hospital, Milano, Italy., Del Vecchio A; Medical Physics, IRCCS San Raffaele Hospital, Milano, Italy., Di Muzio NG; Radiotherapy, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy., Chiti A; Nuclear Medicine, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy., Rosati R; Gastric Surgery, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy., De Cobelli F; Radiology, IRCCS San Raffaele Hospital, Milano, Italy; Vita-Salute University, Milano, Italy.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 May; Vol. 194, pp. 110160. Date of Electronic Publication: 2024 Feb 16.
DOI: 10.1016/j.radonc.2024.110160
Abstrakt: Purpose: The early regression index (ERI) predicts treatment response in rectal cancer patients. Aim of current study was to prospectively assess tumor response to neoadjuvant chemo-radiotherapy (nCRT) of locally advanced esophageal cancer using ERI, based on MRI.
Material and Methods: From January 2020 to May 2023, 30 patients with esophageal cancer were enrolled in a prospective study (ESCAPE). PET-MRI was performed: i) before nCRT (t pre ); ii) at mid-radiotherapy, t mid ; iii) after nCRT, 2-6 weeks before surgery (t post ); nCRT delivered 41.4 Gy/23fr with concurrent carboplatin and paclitaxel. For patients that skipped surgery, complete clinical response (cCR) was assessed if patients showed no local relapse after 18 months; patients with pathological complete response (pCR) or with cCR were considered as complete responders (pCR + cCR). GTV volumes were delineated by two observers (V pre , V mid , V post ) on T2w MRI: ERI and other volume regression parameters at t mid and t post were tested as predictors of pCR + cCR.
Results: Complete data of 25 patients were available at the time of the analysis: 3/25 with complete response at imaging refused surgery and 2/3 were cCR; in total, 10/25 patients showed pCR + cCR (pCR = 8/22). Both ERI mid and ERI post classified pCR + cCR patients, with ERI mid showing better performance (AUC:0.78, p = 0.014): A two-variable logistic model combining ERI mid and V pre improved performances (AUC:0.93, p < 0.0001). Inter-observer variability in contouring GTV did not affect the results.
Conclusions: Despite the limited numbers, interim analysis of ESCAPE study suggests ERI as a potential predictor of complete response after nCRT for esophageal cancer. Further validation on larger populations is warranted.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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