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Tumor volume changes assessed by three-dimensional magnetic resonance volumetry in rectal cancer patients after preoperative chemoradiation: the impact of the volume reduction ratio on the prediction of pathologic complete response.

Authors
Kang, JH; Kim, YC; Kim, H; Kim, YW; Hur, H; Kim, JS; Min, BS; Lim, JS; Seong, J; Keum, KC; Kim, NK
Citation
International journal of radiation oncology, biology, physics, 76(4):1018-1025, 2010
Journal Title
International journal of radiation oncology, biology, physics
ISSN
0360-30161879-355X
Abstract
PURPOSE: The aim of this study was to determine the correlation between tumor volume changes assessed by three-dimensional (3D) magnetic resonance (MR) volumetry and the histopathologic tumor response in rectal cancer patients undergoing preoperative chemoradiation therapy (CRT).



METHODS AND MATERIALS: A total of 84 patients who underwent preoperative CRT followed by radical surgery were prospectively enrolled in the study. The post-treatment tumor volume and tumor volume reduction ratio (% decrease ratio), as shown by 3D MR volumetry, were compared with the histopathologic response, as shown by T and N downstaging and the tumor regression grade (TRG).



RESULTS: There were no significant differences in the post-treatment tumor volume and the volume reduction ratio shown by 3D MR volumetry with respect to T and N downstaging and the tumor regression grade. In a multivariate analysis, the tumor volume reduction ratio was not significantly associated with T and N downstaging. The volume reduction ratio (>75%, p = 0.01) and the pretreatment carcinoembryonic antigen level (< or =3 ng/ml, p = 0.01), but not the post-treatment volume shown by 3D MR (< or = 5 ml), were, however, significantly associated with an increased pathologic complete response rate.



CONCLUSION: More than 75% of the tumor volume reduction ratios were significantly associated with a high pathologic complete response rate. Therefore, limited treatment options such as local excision or simple observation might be considered after preoperative CRT in this patient population.
MeSH terms
AdultAgedAntineoplastic Combined Chemotherapy Protocols/therapeutic useCombined Modality Therapy/methodsDigital Rectal ExaminationFemaleHumansImaging, Three-Dimensional/methodsMagnetic Resonance Imaging/methodsMaleMiddle AgedNeoplasm StagingProspective StudiesRadiotherapy, Conformal*Rectal Neoplasms/drug therapy/pathology/radiotherapy/surgeryRemission Induction*Tumor Burden
DOI
10.1016/j.ijrobp.2009.03.066
PMID
19647949
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
김, 영철
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