Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Street, Chengdu, 610041, Sichuan, China.
Operating Room, Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Abdom Radiol (NY). 2024 Mar;49(3):774-782. doi: 10.1007/s00261-023-04115-5. Epub 2023 Nov 24.
Increasing studies have focused on neoadjuvant chemotherapy (NCT) in rectal cancer. However, few studies explored the differences in radiographic variation between patients treated with NCT and neoadjuvant chemoradiotherapy (NCRT).
Stage II/III rectal cancer patients from March 2016 to December 2019 meeting the criteria treated with NCRT or NCT were included. MRI features, including tumor location, longitudinal length, DWI signal, MRI tumor regression grade (mrTRG), and radiomic texture features, before and after neoadjuvant treatments were reviewed.
116 patients with NCRT and 61 with NCT were analyzed. Among these patients, 46 patients in the NCRT group and 18 in the NCT group were responders with pathological TRG0-1. Within these responders, the mean tumor longitudinal length regression rate (TLRR) of the NCT group was 60.08 ± 11.17%, which was significantly higher than the 50.73 ± 15.28% of the NCRT group (p = 0.010). The proportion of high signal in the DWI image after NCT was higher than that of the NCRT group (88.89% vs 50.00%, p = 0.004). NCT responders had significantly higher median change rates than those of NCRT responders in 11 radiomic features, especially those shape features.
MRI images change differently between responders treated with NCRT and those with NCT in rectal cancer. The tumor volumetry and some radiomic features change more obviously in NCT responders, and the tumor signal changes more obviously in NCRT responders. During the evaluation of the response of the tumor to the neoadjuvant treatments, images of patients should be treated differently.
越来越多的研究集中在直肠癌的新辅助化疗（NCT）上。然而，很少有研究探讨接受 NCT 和新辅助放化疗（NCRT）治疗的患者之间影像学变化的差异。
纳入 2016 年 3 月至 2019 年 12 月符合 NCRT 或 NCT 治疗标准的 II/III 期直肠癌患者。回顾分析新辅助治疗前后的 MRI 特征，包括肿瘤位置、纵向长度、DWI 信号、MRI 肿瘤消退分级（mrTRG）和放射组学纹理特征。
共分析了 116 例接受 NCRT 和 61 例接受 NCT 的患者。在这些患者中，NCRT 组有 46 例和 NCT 组有 18 例病理 TRG0-1 为应答者。在这些应答者中，NCT 组的肿瘤纵向长度缓解率（TLRR）平均值为 60.08±11.17%，明显高于 NCRT 组的 50.73±15.28%（p=0.010）。NCT 组治疗后 DWI 图像高信号比例高于 NCRT 组（88.89%比 50.00%，p=0.004）。NCT 应答者在 11 个放射组学特征中的中位数变化率明显高于 NCRT 应答者，特别是形态特征。
直肠癌患者接受 NCRT 和 NCT 治疗后，MRI 图像变化不同。NCT 应答者的肿瘤体积和一些放射组学特征变化更明显，NCRT 应答者的肿瘤信号变化更明显。在评估肿瘤对新辅助治疗的反应时，应区别对待患者的图像。
