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Background and purpose: Patients with rectal cancer could avoid major surgery if they achieve clinical complete response (cCR) post neoadjuvant treatment. Therefore, prediction of treatment outcomes before treatment has become necessary to select the best neo-adjuvant treatment option. This study investigates clinical and radiomics variables' ability to predict cCR in patients pre chemoradiotherapy. Materials and methods: Using the OnCoRe database, we recruited a matched cohort of 304 patients (152 with cCR; 152 without cCR) deriving training (N = 200) and validation (N = 104) sets. We collected pre-treatment MR (magnetic resonance) images, demographics and blood parameters (haemoglobin, neutrophil, lymphocyte, alkaline phosphate and albumin). We segmented the gross tumour volume on T2 Weighted MR Images and extracted 1430 stable radiomics features per patient. We used principal component analysis (PCA) and receiver operating characteristic area under the curve (ROC AUC) to reduce dimensionality and evaluate the models produced. Results: Using Logistic regression analysis, PCA-derived combined model (radiomics plus clinical variables) gave a ROC AUC of 0.76 (95% CI: 0.69-0.83) in the training set and 0.68 (95% CI 0.57-0.79) in the validation set. The clinical only model achieved an AUC of 0.73 (95% CI 0.66-0.80) and 0.62 (95% CI 0.51-0.74) in the training and validation set, respectively. The radiomics model had an AUC of 0.68 (95% CI 0.61-0.75) and 0.66 (95% CI 0.56-0.77) in the training and validation sets. Conclusion: The predictive characteristics of both clinical and radiomics variables for clinical complete response remain modest but radiomics predictability is improved with addition of clinical variables.
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PURPOSE: To examine the clinical benefits and toxicities of 223Ra in 2 different age groups of patients with castrate-resistant prostate cancer. METHODS AND MATERIALS: This was a retrospective study of patients treated with 223Ra in 2 tertiary centers. Patients were divided into 2 different groups based on their age (≥72 years old and <72 years old). Treatment toxicities were graded according to Common Terminology Criteria for Adverse Events version 4.0. Comparison of characteristics and outcome was carried out with the Mann-Whitney test and analysis of overall survival with the log-rank test. RESULTS: In all, 129 patients were treated during the study period. Clinical benefit was similar in both groups. However, a statistically significant higher proportion of patients in the younger group had previously been treated with docetaxel. There was a higher rate of grade 3 anemia in younger patients. CONCLUSIONS: In line with other studies, 223Ra was well tolerated with minimum toxicities. The significantly higher rate of grade 3 anemia in younger patients may be due to more cautious patient selection in the elderly population.
