Diffusion-weighted magnetic resonance imaging as an early prognostic marker of chemoradiotherapy response in squamous cell carcinoma of the anus: An individual patient data meta-analysis

IF 3.4 Q2 ONCOLOGY
Bettina A. Hanekamp , Pradeep S. Virdee , Vicky Goh , Michael Jones , Rasmus Hvass Hansen , Helle Hjorth Johannesen , Anselm Schulz , Eva Serup-Hansen , Marianne G. Guren , Rebecca Muirhead
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引用次数: 0

Abstract

Background and purpose

Squamous cell carcinoma of the anus (SCCA) can recur after chemoradiotherapy (CRT). Early prediction of treatment response is crucial for individualising treatment. Existing data on radiological biomarkers is limited and contradictory. We performed an individual patient data meta-analysis (IPM) of four prospective trials investigating whether diffusion-weighted (DW) magnetic resonance imaging (MRI) in weeks two to three of CRT predicts treatment failure in SCCA.

Material and methods

Individual patient data from four trials, including paired DW-MRI at baseline and during CRT, were combined into one dataset. The association between ADC volume histogram parameters and treatment failure (locoregional and any failure) was assessed using logistic regression. Pre-defined analysis included categorising patients into a change in the mean ADC of the delineated tumour volume above and below 20%.

Results

The study found that among all included 142 patients, 11.3 % (n = 16) had a locoregional treatment failure. An ADC mean change of <20 % and >20 % resulted in a locoregional failure rate of 16.7 % and 8.0 %, respectively. However, no other ADC-based histogram parameter was associated with locoregional or any treatment failure.

Conclusions

DW-MRI standard parameters, as an isolated biomarker, were not found to be associated with increased odds of treatment failure in SCCA in this IPM. Radiological biomarker investigations involve multiple steps and can result in heterogeneous data. In future, it is crucial to include radiological biomarkers in large prospective trials to minimize heterogeneity and maximize learning.

弥散加权磁共振成像作为肛门鳞状细胞癌化疗反应的早期预后标志:个体患者数据荟萃分析
背景和目的肛门鳞状细胞癌(SCCA)在化疗放疗(CRT)后可能复发。早期预测治疗反应对于个体化治疗至关重要。现有的放射学生物标志物数据有限且相互矛盾。我们对四项前瞻性试验的患者个体数据进行了荟萃分析(IPM),研究CRT第二至三周的弥散加权(DW)磁共振成像(MRI)是否能预测SCCA的治疗失败。材料与方法将四项试验的患者个体数据(包括基线和CRT期间的配对DW-MRI)合并为一个数据集。使用逻辑回归评估了ADC体积直方图参数与治疗失败(局部失败和任何失败)之间的关联。预先定义的分析包括将患者分为划定肿瘤体积的 ADC 平均值变化高于和低于 20% 的两类。结果研究发现,在所有纳入的 142 例患者中,11.3%(n = 16)的患者出现局部治疗失败。ADC平均变化为20%和20%时,局部治疗失败率分别为16.7%和8.0%。结论 在这项 IPM 中,DW-MRI 标准参数作为一种孤立的生物标志物,并未发现与 SCCA 治疗失败几率增加有关。放射学生物标志物研究涉及多个步骤,可能会产生不同的数据。今后,将放射学生物标志物纳入大型前瞻性试验至关重要,以最大限度地减少异质性并最大限度地提高学习效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Physics and Imaging in Radiation Oncology
Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation
CiteScore
5.30
自引率
18.90%
发文量
93
审稿时长
6 weeks
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