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Longitudinal Changes in Tumor Perfusion Pattern during the Radiation Therapy Course and its Clinical Impact in Cervical Cancer

Mayr, Nina A., M.D ; Wang, Jian Z., Ph.D ; Zhang, Dongqing, Ph.D ; Grecula, John C., M.D ; Lo, Simon S., M.D ; Jaroura, David, Ph.D ; Montebello, Joseph, M.D ; Zhang, Hualin, Ph.D ; Li, Kaile, Ph.D ; Lu, Lanchun, Ph.D ; Huang, Zhibin, Ph.D ; Fowler, Jeffery M., M.D ; Wu, Dee H., Ph.D ; Knopp, Michael V., M.D., Ph.D ; Yuh, William T.C., M.D., M.S.E.E

International journal of radiation oncology, biology, physics, 2010-06, Vol.77 (2), p.502-508 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Longitudinal Changes in Tumor Perfusion Pattern during the Radiation Therapy Course and its Clinical Impact in Cervical Cancer
Autor: Mayr, Nina A., M.D ; Wang, Jian Z., Ph.D ; Zhang, Dongqing, Ph.D ; Grecula, John C., M.D ; Lo, Simon S., M.D ; Jaroura, David, Ph.D ; Montebello, Joseph, M.D ; Zhang, Hualin, Ph.D ; Li, Kaile, Ph.D ; Lu, Lanchun, Ph.D ; Huang, Zhibin, Ph.D ; Fowler, Jeffery M., M.D ; Wu, Dee H., Ph.D ; Knopp, Michael V., M.D., Ph.D ; Yuh, William T.C., M.D., M.S.E.E
Assuntos: Adenocarcinoma - blood supply ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Squamous Cell - blood supply ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - radiotherapy ; Cervical cancer ; CONTROL ; DIAGNOSTIC TECHNIQUES ; Disease-Free Survival ; DISEASES ; Female ; Female genital diseases ; Functional Dynamic contrast-enhanced magnetic resonance imaging ; Gynecology. Andrology. Obstetrics ; Hematology, Oncology and Palliative Medicine ; Humans ; Longitudinal changes during therapy ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Medical sciences ; MEDICINE ; Middle Aged ; NEOPLASMS ; NMR IMAGING ; NUCLEAR MEDICINE ; Oxygen Consumption ; Prospective Studies ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Reoxygenation ; SURVIVAL CURVES ; THERAPY ; Time Factors ; Treatment Outcome ; Tumor perfusion ; Tumors ; UROGENITAL SYSTEM DISEASES ; Uterine Cervical Neoplasms - blood supply ; Uterine Cervical Neoplasms - mortality ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - radiotherapy
É parte de: International journal of radiation oncology, biology, physics, 2010-06, Vol.77 (2), p.502-508
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Descrição: Purpose To study the temporal changes of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion patterns during the radiation therapy (RT) course and their influence on local control and survival in cervical cancer. Methods and Materials DCE-MRI was performed in 98 patients with Stage IB2 –IVA cervical cancer before RT (pre-RT) and during early RT (20–25 Gy) and mid-RT (45–50 Gy). Signal intensity (SI) from the DCE-MRI time–SI curve was derived for each tumor voxel. The poorly perfused low-DCE tumor subregions were quantified as lower 10th percentiles of SI (SI10). Local control, disease-specific survival, and overall survival were correlated with DCE parameters at pre-RT, early RT, and mid-RT. Median follow-up was 4.9 (range, 0.2–9.0) years. Results Patients (16/98) with initial pre-RT high DCE (SI10 ≥2.1) had 100% 5-year local control, 81% disease-specific survival, and 81% overall survival, compared with only 79%, 61%, and 55%, respectively, in patients with pre-RT low DCE. Conversion from pre-RT low DCE to high DCE in early RT (28/82 patients) was associated with higher local control, disease-specific survival, and overall survival (93%, 74%, and 67%, respectively). In comparison with all other groups, outcome was worst in patients with persistently low DCE from pre-RT throughout the mid-RT phase (66%, 44%, and 43%; p = 0.003, 0.003, and 0.020; respectively). Conclusion Longitudinal tumor perfusion changes during RT correlate with treatment outcome. Persistently low perfusion in pre-RT, early RT, and mid-RT indicates a high risk of treatment failure, whereas outcome is favorable in patients with initially high perfusion or subsequent improvements of initially low perfusion. These findings likely reflect reoxygenation and may have potential for noninvasive monitoring of intra-treatment radio-responsiveness and for guiding adaptive therapy.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Longitudinal Changes in Tumor Perfusion Pattern during the Radiation Therapy Course and its Clinical Impact in Cervical Cancer

New York, NY: Elsevier Inc

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