Predicting Response to Total Neoadjuvant Treatment (TNT) in Locally Advanced Rectal Cancer Based on Multiparametric Magnetic Resonance Imaging: A Retrospective Study

• Published in: Cancer management and research Vol. 13; pp. 5657 - 5669
• Main Authors: Ouyang, Ganlu, Yang, Xibiao, Deng, Xiangbing, Meng, Wenjian, Yu, Yongyang, Wu, Bing, Jiang, Dan, Shu, Pei, Wang, Ziqiang, Yao, Jin, Wang, Xin
• Format: Journal Article
• Language: English
• Published: Macclesfield Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Adjuvant treatment; Cancer; Cancer therapies; Chemotherapy; Colorectal cancer; Lymphatic system; Magnetic resonance imaging; mri; Oncology, Experimental; Original Research; Radiation therapy; rectal cancer; Rectum; response; Surgery; total neoadjuvant treatment; trg; China
• ISSN: 1179-1322; 1179-1322
• DOI: 10.2147/CMAR.S311501

Purpose: To investigate the potential value of magnetic resonance imaging (MRI) in predicting response relevance to total neoadjuvant treatment (TNT) in locally advanced rectal cancer. Methods: We analyzed MRI of 71 patients underwent TNT from 2015 to 2017 retrospectively. We categorized the response of TNT as CR (complete response) vs non-CR, and high vs moderate vs low sensitivity. Logistic regression analysis was used to identify the best predictors of response. Diagnostic performance was assessed using receiver operating characteristic curve analysis. Results: Post-ICT (induction chemotherapy) [DELTA]TL (tumor length), post-CRT (concurrent chemoradiotherapy) [DELTA]LNN (the numbers of lymph node metastases), post-CCT (consolidation chemotherapy) [DELTA][S.sub.DWI] (maximum cross-sectional area of tumor on diffusion-weighted imaging), post-CCT [ADC.sub.T] (the mean apparent diffusion coefficient values of tumor) and post-CCT [DELTA]LNV (volume of lymph node) were the best CR predictors. Post-ICT [DELTA]TL, post-CRT EMVI (extramural vascular invasion) and post-CCT [DELTA][S.sub.T2] (S on T2-weight) were the best significant factors for high sensitivity. Conclusion: Post-ICT [DELTA]TL may be an early predictor of CR and high sensitivity to TNT. Dynamic analysis based on MRI between baseline and post-CCT could provide the most valuable prediction of CR. The grouping modality of CR vs non-CR may be more suitable for treatment response prediction than high vs moderate vs low sensitivity. Keywords: rectal cancer, total neoadjuvant treatment, MRI, response, TRG