Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Int J Radiat Oncol Biol Phys. 2010 Sep 1;78(1):164-71. doi: 10.1016/j.ijrobp.2009.07.1682. Epub 2009 Dec 11.
To determine whether the tumor volume reduction rate (TVRR) measured using three-dimensional region-of-interest magnetic resonance volumetry correlates with the pathologic tumor response after preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer.
The study included 405 patients with locally advanced rectal cancer (cT3-T4) who had undergone preoperative CRT and radical proctectomy. The tumor volume was measured using three-dimensional region-of-interest magnetic resonance volumetry before and after CRT but before surgery. We analyzed the correlation between the TVRR and the pathologic tumor response in terms of downstaging and tumor regression grade (TRG). Downstaging was defined as ypStage 0-I (ypT0-T2N0M0), and the TRG proposed by Dworak et al. was used.
The mean TVRR was 65.0% +/- 22.3%. Downstaging and complete regression occurred in 167 (41.2%) and 58 (14.3%) patients, respectively. The TVRRs according to ypT classification (ypT0-T2 vs. ypT3-T4), ypN classification (ypN0 vs. ypN1-N2), downstaging (ypStage 0-I vs. ypStage II-III), good regression (TRG 3-4 vs. TRG 1-2), and complete regression (TRG 4 vs. TRG 1-3) were all significantly different (p <.05). When the TVRR was categorized into three groups (<60%, 60-80%, and >80%), the rates of ypT0-T2, ypN0, downstaging, and good regression were all significantly greater for patients with a TVRR of >or=60%, as was the complete regression rate for patients with a TVRR >80% (p <.05).
The TVRR measured using three-dimensional region-of-interest magnetic resonance volumetry correlated significantly with the pathologic tumor response in terms of downstaging and TRG after preoperative CRT for locally advanced rectal cancer.
确定使用三维感兴趣区磁共振体积测量的肿瘤体积缩小率（TVRR）是否与局部晚期直肠癌术前放化疗（CRT）后的病理肿瘤反应相关。
本研究纳入了 405 例接受术前 CRT 和根治性直肠切除术的局部晚期直肠癌（cT3-T4）患者。在 CRT 前但在手术前使用三维感兴趣区磁共振体积测量法测量肿瘤体积。我们分析了 TVRR 与降期和肿瘤消退分级（TRG）的病理肿瘤反应之间的相关性。降期定义为ypStage 0-I（ypT0-T2N0M0），使用 Dworak 等人提出的 TRG。
平均 TVRR 为 65.0% +/- 22.3%。167 例（41.2%）和 58 例（14.3%）患者发生降期和完全消退。根据 ypT 分类（ypT0-T2 与 ypT3-T4）、ypN 分类（ypN0 与 ypN1-N2）、降期（ypStage 0-I 与 ypStage II-III）、良好消退（TRG 3-4 与 TRG 1-2）和完全消退（TRG 4 与 TRG 1-3）的 TVRR 均有显著差异（p<.05）。当 TVRR 分为三组（<60%、60-80%和>80%）时，TVRR≥60%的患者 ypT0-T2、ypN0、降期和良好消退的比例均显著更高，而 TVRR>80%的患者完全消退的比例也更高（p<.05）。
使用三维感兴趣区磁共振体积测量的 TVRR 与局部晚期直肠癌术前 CRT 后的降期和 TRG 显著相关。
