Abstract

PurposeTo evaluate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in treatment response to concurrent chemoradiotherapy (CCRT) for locally advanced cervical squamous cell carcinoma (LACSC).Methods and materialsLACSC patients underwent CCRT had DCE-MRI before (e0) and after 3 days of treatment (e3). Extended Tofts Linear model with a user arterial input function was adopted to generate quantitative measurements. Endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), and fractional plasma volume (Vp) were calculated, and percentage changes ΔKtrans, ΔKep, ΔVe, and ΔVp were computed. The correlations of these measurements with the tumor regression rate were analyzed. The predictive value of these parameters on treatment outcome was generated by the receiver operating characteristic (ROC) curve. Univariate and multivariate logistic regression analyses were conducted to find the independent variables.ResultsKtrans-e0, Kep -e0, ΔKtrans, and ΔVe were positively correlated with the tumor regression rate. Mean values of Ktrans-e0, Ktrans-e3, ΔKtrans, and ΔVe were higher in the non-residual tumor group than residual tumor group and were independent prognostic factors for predicting residual tumor occurrence. Ktrans-e3 showed the highest area under the curve (AUC) for treatment response prediction.ConclusionsQuantitative parameters at e0 and e3 from DCE-MRI could be used as potential indicators for predicting treatment response of LACSC.

Highlights

  • Cervical cancer is the fourth leading cause of cancer death in women worldwide [1]

  • Quantitative parameters at e0 and e3 from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could be used as potential indicators for predicting treatment response of locally advanced cervical squamous cell carcinoma (LACSC)

  • The mean tumor volume before treatment was 45.64 cm3(range 11.3–192.7 cm3) and 19.84 cm3 at I month after Concurrent chemoradiotherapy (CCRT)

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Summary

Introduction

Cervical cancer is the fourth leading cause of cancer death in women worldwide [1]. Concurrent chemoradiotherapy (CCRT) is the primary choice for locally advanced cervical cancer patients, with significant benefits even for the advancedstage disease [2]. The alternative or novel treatment modalities could potentially improve treatment outcomes further, there is concern regarding treatment toxicity and complications in survivors [3]. Even with the same clinical stage and pathological subtype, the prognosis differs among patients, which indicates tumor heterogeneity and distinct radio-sensitivity. Techniques providing composite prognostic information than current clinical prognostic factors like stage, grade, histology, and patients comorbidities would allow individualization of treatment [4]. Techniques that reflect biological changes during the complex process of chemoradiotherapy are of great importance

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