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Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer
PURPOSE: Reassessment tools of response to long-course neoadjuvant chemoradiation treatment (nCRT) in patients with locally advanced rectal cancer (LARC) are important in predicting complete response (CR) and thus deciding whether a wait-and-watch strategy can be implemented in these patients. Choos...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569175/ https://www.ncbi.nlm.nih.gov/pubmed/36243807 http://dx.doi.org/10.1007/s00384-022-04268-7 |
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author | Chen, Junbing Wu, Zhouqiao Zhang, Xiaoyan Liu, Zining Wang, Yiding Shan, Fei Wang, Yinkui Xia, Shaojun Zhang, Yan Sun, Yingshi Ji, Jiafu Li, Ziyu |
author_facet | Chen, Junbing Wu, Zhouqiao Zhang, Xiaoyan Liu, Zining Wang, Yiding Shan, Fei Wang, Yinkui Xia, Shaojun Zhang, Yan Sun, Yingshi Ji, Jiafu Li, Ziyu |
author_sort | Chen, Junbing |
collection | PubMed |
description | PURPOSE: Reassessment tools of response to long-course neoadjuvant chemoradiation treatment (nCRT) in patients with locally advanced rectal cancer (LARC) are important in predicting complete response (CR) and thus deciding whether a wait-and-watch strategy can be implemented in these patients. Choosing which routine reassessment tools are optimal and when to use them is still unclear and will be researched in the study. METHODS: Altogether, 250 patients with LARC who received nCRT from 2013 to 2021 and were followed up were retrospectively reviewed. Common reassessment tools of response included digital rectal examination (DRE), clinical examination and symptoms, endoscopy, biopsy, magnetic resonance imaging (MRI), and blood biomarkers. RESULTS: Overall, 27.20% (68/250) patients had a complete response and 72.80% (182/250) did not. The combination of MRI, endoscopy, and biopsy showed the best performance in terms of accuracy of 74% and area under the curve (AUC, 0.714, 95% CI 0.546–0.882). Reassessing through DRE and presence of symptoms failed to improve the efficacy of response reassessment. After 100 days, biopsy as an assessment tool would obtain a substantial rise in accuracy from 51.28 to 100% (p = 0.003). CONCLUSION: The combination of MRI, endoscopy, and biopsy is suitable as the reassessment tool of response for applying a wait-and-watch strategy after long-course nCRT in patients with LARC. The accuracy of biopsy as reassessment tools would be improved if they were used over 100 days after nCRT in patients with rectal cancer. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00384-022-04268-7. |
format | Online Article Text |
id | pubmed-9569175 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-95691752022-10-16 Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer Chen, Junbing Wu, Zhouqiao Zhang, Xiaoyan Liu, Zining Wang, Yiding Shan, Fei Wang, Yinkui Xia, Shaojun Zhang, Yan Sun, Yingshi Ji, Jiafu Li, Ziyu Int J Colorectal Dis Research PURPOSE: Reassessment tools of response to long-course neoadjuvant chemoradiation treatment (nCRT) in patients with locally advanced rectal cancer (LARC) are important in predicting complete response (CR) and thus deciding whether a wait-and-watch strategy can be implemented in these patients. Choosing which routine reassessment tools are optimal and when to use them is still unclear and will be researched in the study. METHODS: Altogether, 250 patients with LARC who received nCRT from 2013 to 2021 and were followed up were retrospectively reviewed. Common reassessment tools of response included digital rectal examination (DRE), clinical examination and symptoms, endoscopy, biopsy, magnetic resonance imaging (MRI), and blood biomarkers. RESULTS: Overall, 27.20% (68/250) patients had a complete response and 72.80% (182/250) did not. The combination of MRI, endoscopy, and biopsy showed the best performance in terms of accuracy of 74% and area under the curve (AUC, 0.714, 95% CI 0.546–0.882). Reassessing through DRE and presence of symptoms failed to improve the efficacy of response reassessment. After 100 days, biopsy as an assessment tool would obtain a substantial rise in accuracy from 51.28 to 100% (p = 0.003). CONCLUSION: The combination of MRI, endoscopy, and biopsy is suitable as the reassessment tool of response for applying a wait-and-watch strategy after long-course nCRT in patients with LARC. The accuracy of biopsy as reassessment tools would be improved if they were used over 100 days after nCRT in patients with rectal cancer. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00384-022-04268-7. Springer Berlin Heidelberg 2022-10-15 2022 /pmc/articles/PMC9569175/ /pubmed/36243807 http://dx.doi.org/10.1007/s00384-022-04268-7 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Research Chen, Junbing Wu, Zhouqiao Zhang, Xiaoyan Liu, Zining Wang, Yiding Shan, Fei Wang, Yinkui Xia, Shaojun Zhang, Yan Sun, Yingshi Ji, Jiafu Li, Ziyu Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
title | Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
title_full | Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
title_fullStr | Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
title_full_unstemmed | Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
title_short | Optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
title_sort | optimized tools and timing of response reassessment after neoadjuvant chemoradiation in rectal cancer |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569175/ https://www.ncbi.nlm.nih.gov/pubmed/36243807 http://dx.doi.org/10.1007/s00384-022-04268-7 |
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