Magnetic resonance imaging tumor response score (mrTRS) predicts therapeutic effect and prognosis of locally advanced rectal cancer after neoadjuvant chemoradiotherapy: A prospective, multi-center study.
Radiother Oncol
; 151: 288-295, 2020 10.
Article
en En
| MEDLINE
| ID: mdl-32890612
BACKGROUND AND PURPOSE: The MRI-assessed tumor regression grade (mrTRG) is limited due to its subjectivity and poor consistency on pathological tumor regression grade (pTRG). A new MRI criterion was established to predict the prognosis of locally advanced rectal cancer (LARC). MATERIALS AND METHODS: The new MRI criterion magnetic resonance imaging tumor response score (mrTRS) was based on the retrospective sample of 214 LARC patients (unpublished data). Subsequently, 878 LARC patients were enrolled for a prospective, multicenter study. Baseline and postoperative MRI were obtained, and imaging features were measured by collecting the pathological, clinical and follow-up data. Kaplan-Meier method with log-rank estimate and multivariate cox regression model was used to determine the prognosis of mrTRS in LARC patients with neoadjuvant chemoradiotherapy (NACRT). The predictive capability of 3-year prognosis between mrTRS and mrTRG was determined by time-dependent ROC curves. RESULTS: The results demonstrated that mrTRS acted as an independent predictor of survival outcomes. mrTRS stratified by good and moderate responders showed significantly lower risk of death (HR = 0.04, 95%CI 0.01-0.31; HR = 0.35, 95%CI 0.23-0.52), distant metastasis (HR = 0.25, 95%CI 0.13-0.52; HR = 0.42, 95%CI 0.30-0.58), and local recurrence when compared with poor responders(HR = 0.01 95%CI 0.23-0.52;HR = 0.38, 95%CI 0.16-0.90). In contrast, no significant difference was observed among mrTRG stratified groups. Excellent and substantial interobserver agreement for mrTRS and mrTRG evaluation was observed (κ = 0.92 and 0.62), respectively. CONCLUSION: mrTRS can serve as an effective predictor for assessing tumor regression grade in LARC patients with NACRT.
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Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
/
Terapia Neoadyuvante
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Radiother Oncol
Año:
2020
Tipo del documento:
Article
País de afiliación:
China
Pais de publicación:
Irlanda