Treatment response of colorectal cancer liver metastases to neoadjuvant or conversion therapy: a prospective multicentre follow-up study using MRI, diffusion-weighted imaging and 1H-MR spectroscopy compared with histology (subgroup in the RAXO trial)

被引：11

作者：

Uutela, A. ^{[1
,2
]}

Ovissi, A. ^{[2
,3
]}

Hakkarainen, A. ^{[2
,3
,4
]}

Ristimaki, A. ^{[2
,5
]}

Lundbom, N. ^{[2
,3
]}

Kallio, R. ^{[6
]}

Soveri, L. M. ^{[7
]}

Salminen, T. ^{[8
,9
]}

Algars, A. ^{[10
,11
]}

Halonen, P. ^{[2
,12
]}

Ristamaki, R. ^{[10
,11
]}

Nordin, A. ^{[1
,2
]}

Sequeiros, R. Blanco ^{[11
,13
,14
]}

Rinta-Kiikka, I. ^{[15
,16
]}

Lantto, E. ^{[17
]}

Virtanen, J. ^{[11
,13
]}

Paakko, E. ^{[14
]}

Liukkonen, E. ^{[14
]}

Saunavaara, J. ^{[11
,13
]}

Ryymin, P. ^{[15
,16
]}

Lammentausta, E. ^{[14
]}

Osterlund, P. ^{[2
,8
,9
,12
,18
,19
]}

Isoniemi, H. ^{[1
,2
]}

机构：

[1] Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Helsinki, Finland

[2] Univ Helsinki, Helsinki, Finland

[3] Helsinki Univ Hosp, HUS Med Imaging Ctr, Dept Radiol, Helsinki, Finland

[4] Aalto Univ, Sch Sci, Dept Neurosci & Biomed Engn, Helsinki, Finland

[5] Helsinki Univ Hosp, Res Programs Unit, HUS Diagnost Ctr & Appl Tumour Gen, Dept Pathol, Helsinki, Finland

[6] Oulu Univ Hosp, Dept Oncol, Oulu, Finland

[7] Home Care Geriatr Clin & Palliat Care, Joint Municipal Author Hlth Care & Social Serv, Hyvinkaa, Finland

[8] Tampere Univ Hosp, Dept Oncol, Teiskontie 35, Tampere 33520, Finland

[9] Univ Tampere, Teiskontie 35, Tampere 33520, Finland

[10] Turku Univ Hosp, Dept Oncol, Turku, Finland

[11] Univ Turku, Turku, Finland

[12] Helsinki Univ Hosp, Ctr Comprehens Canc, Dept Oncol, Helsinki, Finland

[13] Turku Univ Hosp, Dept Radiol, Turku, Finland

[14] Oulu Univ Hosp, Dept Radiol, Oulu, Finland

[15] Tampere Univ Hosp, Med Imaging Ctr, Dept Radiol, Tampere, Finland

[16] Tampere Univ Hosp, Med Imaging Ctr, Dept Med Phys, Tampere, Finland

[17] Paijat Hame Cent Hosp, Dept Radiol, Lahti, Finland

[18] Karolinska Inst, Dept Pathol Oncol, Stockholm, Sweden

[19] Karolinska Sjukhuset Tema Canc, Stockholm, Sweden

来源：

ESMO OPEN | 2021年 / 6卷 / 04期

关键词：

colorectal cancer; liver metastasis; neoadjuvant chemotherapy; liver surgery; diffusion-weighted imaging; magnetic resonance spectroscopy; PATHOLOGICAL RESPONSE; CHEMOTHERAPY; PREDICTION; TUMOR; BEVACIZUMAB; SURVIVAL; CRITERIA; OUTCOMES; SURGERY; FAT;

D O I：

10.1016/j.esmoop.2021.100208

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Colorectal cancer liver metastases respond to chemotherapy and targeted agents not only by shrinking, but also by morphologic and metabolic changes. The aim of this study was to evaluate the value of advanced magnetic resonance imaging (MRI) methods in predicting treatment response and survival. Patients and methods: We investigated contrast-enhanced MRI, apparent diffusion coefficient (ADC) in diffusionweighted imaging and H-1-magnetic resonance spectroscopy (1H-MRS) in detecting early morphologic and metabolic changes in borderline or resectable liver metastases, as a response to first-line neoadjuvant or conversion therapy in a prospective substudy of the RAXO trial (NCT01531621, EudraCT2011-003158-24). MRI findings were compared with histology of resected liver metastases and KaplaneMeier estimates of overall survival (OS). Results: In 2012-2018, 52 patients at four Finnish university hospitals were recruited. Forty-seven patients received neoadjuvant or conversion chemotherapy and 40 liver resections were carried out. Low ADC values (below median) of the representative liver metastases, at baseline and after systemic therapy, were associated with partial response according to RECIST criteria, but not with morphologic MRI changes or histology. Decreasing ADC values following systemic therapy were associated with improved OS compared to unchanged or increasing ADC, both in the liver resected subgroup (5-year OS rate 100% and 34%, respectively, P = 0.022) and systemic therapy subgroup (5-year OS rate 62% and 23%, P = 0.049). H-1-MRS revealed steatohepatosis induced by systemic therapy. Conclusions: Low ADC values at baseline or during systemic therapy were associated with treatment response by RECIST but not with histology, morphologic or detectable metabolic changes. A decreasing ADC during systemic therapy is associated with improved OS both in all patients receiving systemic therapy and in the resected subgroup.

引用

页数：11

共 48 条

[1] Multidisciplinary approach of liver metastases from colorectal cancer [J].