Correlation analysis between MRI parameters and prognosis in locally advanced rectal cancer patients receiving chemoradiotherapy
Chen Silin1, Li Shuai2, Li Ning1, Liu Wenyang1, Jiang Liming3, Jiang Jun3, Ren Hua1, Wang Shulian1, Song Yongwen1, Liu Yueping1, Fang Hui1, Lu Ningning1, Tang Yu1, Qi Shunan1, Chen Bo1, Lei Junqin1, Shi Jinming1, Li Yexiong1, Jin Jing1, Tang Yuan1
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China; 3Department of Image, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract：Objective To investigate the relationship between MRI parameters and clinical prognosis before and after chemoradiotherapy in patients with locally advanced rectal cancer. Methods Clinical and follow-up data of 96 patients with locally advanced rectal cancer who were initially treated in the Cancer Hospital of Chinese Academy of Medical Sciences from 2015 to 2017 were retrospectively analyzed. All patients received preoperative chemoradiotherapy, followed by delayed radical surgery at 6-13 weeks after radiotherapy.MRI assessment was performed twice around radiotherapy which were within 4 weeks before the treatment and 4-8 weeks after it.Correlation analysis was utilized to determine the association between MRI assessment and 3-year disease-free survival (DFS). Results Of the all patients, 80 (83%) had T3 stage, 16(17%) had T4 stage, 14 (15%) had N0 stage, and 82 (86%) had N1-2 stage.Among them, 69(72%) and 58(60%) patients were positive for MRF and EMVI. The median dose of radiotherapy was 50Gy, and all patients were sensitized by simultaneous capecitabine. After chemoradiotherapy, T-downstage rate of the whole group was 24%, and 50% for the N-downstage rate. The MRF-and EMVI-positive rates were significantly decreased to 37% and 27% after chemoradiotherapy (both P<0.001). Univariate and multivariate analyses showed that N staging and EMVI status change were significantly correlated with the 3-year DFS. Conclusion MRI after concurrent chemoradiotherapy reveals that positive EMVI throughout the treatment and N1-N2 staing are poor prognostic factors of DFS, suggesting the need for improving the treatment.
Chen Silin,Li Shuai,Li Ning et al. Correlation analysis between MRI parameters and prognosis in locally advanced rectal cancer patients receiving chemoradiotherapy[J]. Chinese Journal of Radiation Oncology, 2020, 29(7): 529-534.
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2020, Vol. 29 
