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Tytuł pozycji:

Accurate outcome prediction after neo-adjuvant radio-chemotherapy for rectal cancer based on a TCP-based early regression index

Tytuł:
Accurate outcome prediction after neo-adjuvant radio-chemotherapy for rectal cancer based on a TCP-based early regression index
Autorzy:
Claudio Fiorino
Paolo Passoni
Anna Palmisano
Calogero Gumina
Giovanni M. Cattaneo
Sara Broggi
Alessandra Di Chiara
Antonio Esposito
Martina Mori
Monica Ronzoni
Riccardo Rosati
Najla Slim
Francesco De Cobelli
Riccardo Calandrino
Nadia G. Di Muzio
Temat:
Medical physics. Medical radiology. Nuclear medicine
R895-920
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Źródło:
Clinical and Translational Radiation Oncology, Vol 19, Iss , Pp 12-16 (2019)
Wydawca:
Elsevier, 2019.
Rok publikacji:
2019
Kolekcja:
LCC:Medical physics. Medical radiology. Nuclear medicine
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Typ dokumentu:
article
Opis pliku:
electronic resource
Język:
English
ISSN:
2405-6308
Relacje:
http://www.sciencedirect.com/science/article/pii/S2405630819300849; https://doaj.org/toc/2405-6308
DOI:
10.1016/j.ctro.2019.07.001
Dostęp URL:
https://doaj.org/article/f9852dbfcab44334afed4a7e17be00e8  Link otwiera się w nowym oknie
Numer akcesji:
edsdoj.f9852dbfcab44334afed4a7e17be00e8
Czasopismo naukowe
Background and purpose: An early tumor regression index (ERITCP) was previously introduced and found to predict pathological response after neo-adjuvant radio-chemotherapy of rectal cancer. ERITCP was tested as a potential biomarker in predicting long-term disease-free survival. Materials and methods: Data of 65 patients treated with an early regression-guided adaptive boosting technique (ART) were available. Overall, loco-regional relapse-free and distant metastasis-free survival (OS, LRFS, DMFS) were considered. Patients received 41.4 Gy in 18 fractions (2.3 Gy/fr), including ART concomitant boost on the residual GTV during the last 6 fractions (3 Gy/fr, Dmean: 45.6 Gy). Chemotherapy included oxaliplatin and 5-fluorouracil (5-FU). T2-weighted MRI taken before (MRIpre) and at half therapy (MRIhalf) were available and GTVs were contoured (Vpre, Vhalf). The parameter ERITCP = −ln[(1 − (Vhalf/Vpre))Vpre] was calculated for all patients. Cox regression models were assessed considering several clinical and histological variables. Cox models not including/including ERITCP (CONV_model and REGR_model respectively) were assessed and their discriminative power compared. Results: At a median follow-up of 47 months, OS, LRFS and DMFS were 94%, 95% and 78%. Due to too few events, multivariable analyses focused on DMFS: the resulting CONV_model included pathological complete remission or clinical complete remission followed by surgery refusal (HR: 0.15, p = 0.07) and 5-FU dose >90% (HR: 0.29, p = 0.03) as best predictors, with AUC = 0.75. REGR_model included ERITCP (HR: 1.019, p 90% (HR: 0.18, p = 0.005); AUC was 0.86, significantly higher than CONV_model (p = 0.05). Stratifying patients according to the best cut-off value for ERITCP and to 5-FU dose (> vs

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