Metabolic positron emission tomography/CT response after induction chemotherapy and chemo(re)irradiation is associated with higher negative resection margin rate in patients with locally recurrent rectal cancer
Autor: | Desley M. G. I. van Zoggel, J. S. Cnossen, J.G. Bloemen, E.L.K. Voogt, Ineke van Lijnschoten, Grard A. P. Nieuwenhuijzen, Sabine G. G. F. Lardenoije, Pim Burger, Geert-Jan Creemers, Joost Nederend, Mark J. Roef, Harm J. T. Rutten |
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Přispěvatelé: | RS: GROW - R2 - Basic and Translational Cancer Biology, Surgery |
Rok vydání: | 2021 |
Předmět: |
Re-Irradiation
PREDICTION Histopathological response WATCH CHEMORADIATION Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Humans CRITERIA Medicine FDG-PET Radiation treatment planning histopathological response Pathological induction chemotherapy Recurrent Rectal Cancer medicine.diagnostic_test Rectal Neoplasms business.industry locally recurrent rectal cancer Gastroenterology Margins of Excision Induction chemotherapy PATHOLOGICAL RESPONSE NEOADJUVANT CHEMORADIOTHERAPY F-18-FDG PET/CT Neoadjuvant Therapy FDG-PET/CT Treatment Outcome RECIST Positron emission tomography Positron-Emission Tomography SURVIVAL Resection margin Neoplasm Recurrence Local Radiopharmaceuticals business Nuclear medicine CT |
Zdroj: | Colorectal Disease, 24(1), 59-67. Wiley |
ISSN: | 1463-1318 1462-8910 |
Popis: | Aim Positron emission tomography (PET)/CT can be used to monitor the metabolic changes that occur after intensified treatment with induction chemotherapy and chemo(re)irradiation for locally recurrent rectal cancer (LRRC). This study aimed to analyse the correlation between the PET/CT response and final histopathological outcomes. Methods All LRRC patients who underwent induction chemotherapy prior to surgery between January 2010 and July 2020 and were monitored with pretreatment and post-treatment PET/CT were included. Visual qualitative analysis was performed, and patients were scored as having achieved a complete metabolic response (CMR), partial metabolic response (PMR) or no response (NR). The histopathological response was assessed according to the Mandard tumour regression (TRG) score and categorized as major (TRG 1-2), partial (TRG 3) or poor (TRG 4-5). The PET/CT and TRG categories were compared, and possible confounders were analysed. Results A total of 106 patients were eligible for analysis; 24 (23%) had a CMR, 54 (51%) had a PMR and 28 (26%) had NR. PET/CT response was a significant predictor of the negative resection margin rate, achieving 96% for CMR, 69% for PMR and 50% for NR. The overall accuracy between PET score and pathological TRG was 45%, and the positive predictive value for CMR was 63%. A longer interval between post-treatment PET/CT and surgery negatively influenced the predictive value. Conclusion Metabolic PET/CT response evaluation after neoadjuvant treatment proves to be a complementary diagnostic tool to standard MRI in assessing tumour response, and may play a role for treatment planning in LRRC patients. |
Databáze: | OpenAIRE |
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