Hanekamp Bettina A, Virdee Pradeep S, Goh Vicky, Jones Michael, Hvass Hansen Rasmus, Hjorth Johannesen Helle, Schulz Anselm, Serup-Hansen Eva, Guren Marianne G, Muirhead Rebecca
Department of Radiology, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Phys Imaging Radiat Oncol. 2024 Jul 31;31:100618. doi: 10.1016/j.phro.2024.100618. eCollection 2024 Jul.
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 -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.
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%.
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.
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.
肛管鳞状细胞癌（SCCA）在放化疗（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。关于放射学生物标志物的现有数据有限且相互矛盾。我们对四项前瞻性试验进行了个体患者数据分析（IPM），以研究CRT第二至三周的扩散加权（DW）磁共振成像（MRI）是否能预测SCCA的治疗失败。
将四项试验的个体患者数据，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ADC体积直方图参数与治疗失败（局部区域和任何失败）之间的关联。预定义分析包括将患者分为所勾画肿瘤体积平均ADC变化高于和低于20%两类。
研究发现，在所有纳入的142例患者中，11.3%（n = 16）出现局部区域治疗失败。ADC平均变化<20%和>20%时，局部区域失败率分别为16.7%和8.0%。然而，没有其他基于ADC的直方图参数与局部区域或任何治疗失败相关。
在这项IPM中，未发现DW-MRI标准参数作为单独的生物标志物与SCCA治疗失败几率增加相关。放射学生物标志物研究涉及多个步骤，可能导致数据异质性。未来，在大型前瞻性试验中纳入放射学生物标志物以尽量减少异质性并最大化研究成果至关重要。
