Abstract
BackgroundPreoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management. However, there is a strong clinical need to assess tumor response to neoadjuvant treatment, and a non-invasive technique that allows the precise identification of morphologic changes in tumors would be of considerable clinical interest.MethodsIn this study, we used multiphoton microscopy (MPM) to detect morphologic alterations in rectal adenocarcinomas in patients treated with preoperative radiochemotherapy.ResultsMPM was able to identify histopathologic alterations in rectal cancer following preoperative radiochemotherapy, and allowed the qualitative assessment of treatment efficacy and feasibility in relation to dose or strategy.ConclusionThese findings may provide the groundwork for evaluating tumor response to neoadjuvant treatment, thus allowing the tailoring of effective treatment doses and strategies.
Highlights
Preoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management
Consecutive muscular tissues were disrupted and collagen fibers were abundant but disordered, as demonstrated by second harmonic generation (SHG) signals (Figure 1(a)). This may be interpreted as former tumor infiltration leading to the destruction of muscular tissues, and post-treatment tumor regression represented by fibrosis or fibroinflammatory changes replacing neoplastic glands [15,16]
The details revealed by multiphoton microscopy (MPM) correlated well with the hematoxylin and eosin (H&E)-stained images (Figure 1(d))
Summary
Preoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management. Accumulating evidence has demonstrated that neoadjuvant treatment improves local control and survival in patients with rectal cancer, and may play an increasing role, especially in locally advanced disease [1,2,3,4,5]. Preoperative radiochemotherapy has been used increasingly in the management of this group of patients. This study investigated the treatment-related morphologic aspects of rectal carcinomas using MPM imaging, with an emphasis on stromal alterations, changes in blood vessels and inflammatory cell infiltrate, and. The study aimed to provide a detailed morphologic description of rectal carcinoma in patients treated with preoperative radiochemotherapy, and to identify patterns of morphologic alterations with prognostic significance. We aimed to determine the efficacy of radiochemotherapy and the appropriateness of the treatment dose and strategy by monitoring theses morphological changes
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