Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Evaluation and Comparison of Predictive Value of Tumor Regression Grades according to Mandard and Becker in Locally Advanced Gastric Adenocarcinoma: Yilin Tong, Yanmei Zhu, Yan Zhao, Zexing Shan, Dong Liu, Jianjun Zhang; Cancer Res Treat. 2021;53(1):112-122. Published online August 10, 2020; DOI: https://doi.org/10.4143/crt.2020.516

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Purpose
Tumor regression grade (TRG) has been widely used in gastrointestinal carcinoma to assess pathological responses to neoadjuvant chemotherapy (NCT). There are various standards without a consensus, and it is still unclear which kind of system has better predictive value. This study aims to investigate and compare the predictive ability of the Mandard and Becker TRGs in patients with locally advanced gastric cancer.
Materials and Methods
A total of 290 patients with locally advanced gastric adenocarcinoma who underwent NCT and curative surgery were studied. Survival analysis for overall survival (OS) and disease-free survival (DFS) were based on the Kaplan-Meier method and Cox proportional hazards method. Predictive values of TRGs and models were assessed by time-dependent receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), nomogram, and calibration curve.
Results
In multivariable analysis, the Mandard TRG was associated with OS (hazard ratio [HR], 1.806; p=0.026) and DFS (HR, 1.792; p=0.017). The Becker TRG was also related to OS (HR, 1.880; p=0.014) and DFS (HR, 1.919; p=0.006). The Mandard and Becker TRG AUCs for 5-year survival were 0.72 and 0.71, respectively. The whole models showed an increased predictive value, with AUCs of 0.85 and 0.86, respectively. There was no significant difference between the two TRGs and two models.
Conclusion
TRG was an independent predictor for survival, and there was no significant difference between these two systems.

Citations

Citations to this article as recorded by

CT-Derived Quantitative Image Features Predict Neoadjuvant Treatment Response in Adenocarcinoma of the Gastroesophageal Junction with High Accuracy
Markus Graf, Sebastian Ziegelmayer, Stefan Reischl, Yannick Teumer, Florian T. Gassert, Alexander W. Marka, Philipp Raffler, Jeannine Bachmann, Marcus Makowski, Daniel Reim, Fabian Lohöfer, Egon Burian, Rickmer Braren
Cancers.2025; 17(2): 216. CrossRef
Microsatellite instability in gastric cancer: An institutional case series analysis in patients treated with neoadjuvant therapy
Laura Lorenzon, Alberto Biondi, Gloria Santoro, Annamaria Agnes, Antonio Laurino, Antonia Strippoli, Riccardo Ricci, Roberto Persiani, Domenico D'Ugo
Clinical Surgical Oncology.2024; 3(1): 100031. CrossRef
The Evolving Landscape of Neoadjuvant Immunotherapy in Gastroesophageal Cancer
Colum Dennehy, Alisha F. Khan, Ali H. Zaidi, Vincent K. Lam
Cancers.2024; 16(2): 286. CrossRef
Evaluating Treatment Response in GEJ Adenocarcinoma
Markus Graf, Joshua Gawlitza, Marcus Makowski, Felix Meurer, Thomas Huber, Sebastian Ziegelmayer
Investigative Radiology.2024; 59(8): 583. CrossRef
Deep learning nomogram for predicting neoadjuvant chemotherapy response in locally advanced gastric cancer patients
Jingjing Zhang, Qiang Zhang, Bo Zhao, Gaofeng Shi
Abdominal Radiology.2024; 49(11): 3780. CrossRef
Intratumoral heterogeneity affects tumor regression and Ki67 proliferation index in perioperatively treated gastric carcinoma
Magnus Kock am Brink, Laura Sophie Dunst, Hans-Michael Behrens, Sandra Krüger, Thomas Becker, Christoph Röcken
British Journal of Cancer.2023; 128(2): 375. CrossRef
Time to Surgery does not Affect Oncologic Outcomes in Locally Advanced Gastric Cancer after Neoadjuvant Chemotherapy: A Meta-Analysis
Zining Liu, Zhening Zhang, Hua Liu, Junbing Chen
Future Oncology.2023; 19(5): 397. CrossRef
Response Evaluation after Neoadjuvant Chemotherapy for Resectable Gastric Cancer
Alina Desiree Sandø, Reidun Fougner, Elin Synnøve Røyset, Hong Yan Dai, Jon Erik Grønbech, Erling Audun Bringeland
Cancers.2023; 15(8): 2318. CrossRef
Profiling complete regression after pre-operative therapy in gastric cancer patients using clinical and pathological data
Alberto Biondi, Laura Lorenzon, Gloria Santoro, Annamaria Agnes, Antonio Laurino, Roberto Persiani, Domenico D'Ugo
European Journal of Surgical Oncology.2023; 49(11): 106969. CrossRef
Concurrent clinical and pathological response predicts favorable prognosis of patients with gastric cancer after neoadjuvant therapy: a real-world study
Chongyuan Sun, Penghui Niu, Xiaojie Zhang, Lulu Zhao, Wanqing Wang, Xiaoyi Luan, Xue Han, Yingtai Chen, Dongbing Zhao
BMC Cancer.2023;[Epub] CrossRef
Sintilimab Plus Fluorouracil, Leucovorin, Oxaliplatin and Docetaxel Regimen as Neoadjuvant Therapy for Resectable Gastric Cancer and Biomarker Exploration
Jiangpeng Wei, Xin Guo, Xisheng Yang, Jinqiang Liu, Qianqian Duan, Yuan Tan, Qin Zhang, Tingting Sun, Chuang Qi, Xiaohua Li, Gang Ji
Future Oncology.2023; 19(36): 2395. CrossRef
Evaluation of dual-energy CT derived radiomics signatures in predicting outcomes in patients with advanced gastric cancer after neoadjuvant chemotherapy
Yong Chen, Fei Yuan, Lingyun Wang, Elsie Li, Zhihan Xu, Michael Wels, Weiwu Yao, Huan Zhang
European Journal of Surgical Oncology.2022; 48(2): 339. CrossRef
MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION
Maria Cecília de Aguiar MACHADO, José Pedro Coimbra de Vargas Lobarinhas BARBOSA, Filipa Ferreira de OLIVEIRA, José Adelino Lobarinhas BARBOSA
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo).2022;[Epub] CrossRef
Validating a nodal regression system for gastric cancer: An ancillary cohort study of the GASTRODOC trial
Luca Saragoni, Leonardo Solaini, Daniele Marrelli, Maria Raffaella Ambrosio, Maria Bencivenga, Anna Tomezzoli, Carlo Milandri, Valentina Terrinazzi, Gian Luca Baiocchi, Carla Baronchelli, Flavia Foca, Giorgio Ercolani, Paolo Morgagni
International Journal of Surgery.2021; 94: 106112. CrossRef
Comparison of tumor regression grading systems for locally advanced gastric adenocarcinoma after neoadjuvant chemotherapy
Zi-Ning Liu, Yin-Kui Wang, Li Zhang, Yong-Ning Jia, Shan Fei, Xiang-Ji Ying, Yan Zhang, Shuang-Xi Li, Yu Sun, Zi-Yu Li, Jia-Fu Ji
World Journal of Gastrointestinal Oncology.2021; 13(12): 2161. CrossRef

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Assessment of Tumor Regression by Consecutive Pelvic Magnetic Resonance Imaging and Dose Modification during High-Dose-Rate Brachytherapy for Carcinoma of the Uterine Cervix: Taek-Keun Nam, Byung-Sik Nah, Ho-Sun Choi, Woong-Ki Chung, Sung-Ja Ahn, Seok-Mo Kim, Ju-Young Song, Mi-Seon Yoon; Cancer Res Treat. 2005;37(3):157-164. Published online June 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.3.157

Abstract PDF PubReader ePub

Purpose

To assess tumor regression, as determined by pelvic magnetic resonance imaging (MRI), and evaluate the efficacies and toxicities of the interim brachytherapy (BT) modification method, according to tumor regression during multi-fractionated high-dose-rate (HDR) BT for uterine cervical cancer.

Materials and Methods

Consecutive MRI studies were performed pre-radiotherapy (RT), pre-BT and during interfraction of BT (inter-BT) in 69 patients with cervical cancer. External beam radiotherapy (EBRT) was performed, using a 10 MV X-ray, in daily fraction of 1.8 Gy with 4-fields, 5 d/wk. Radiation was delivered up to 50.4 Gy, with midline shielding at around 30.6 Gy. Of all 69 patients, 50 received modified interim BT after checking the inter-BT MRI. The BT was delivered in two sessions; the first was composed of several 5 Gy fractions to point A, twice weekly, using three channel applicators. According to the three measured orthogonal diameters of the regressed tumor, based on inter-BT MR images, the initial BT plan was modified, with the second session consisting of a few fractions of less than 5 Gy to point A, using a cervical cylinder applicator.

Results

The numbers of patients in FIGO stages Ib, IIa, IIb and IIIb+IVa were 19 (27.5%), 18 (26.1%), 27 (39.2%) and 5 (7.2%), respectively. Our treatment characteristics were comparable to those from the literatures with respect to the biologically effective dose (BED) to point A, rectum and bladder as reference points. In the regression analysis a significant correlation was observed between tumor regression and the cumulative dose to point A on the follow-up MRI. Nearly 80% regression of the initial tumor volume occurred after 30.6 Gy of EBRT, and this increased to 90% after an additional 25 Gy in 5 fractions of BT, which corresponds to 73.6 Gy of cumulative BED₁₀ to point A. The median total fraction number, and those at the first and second sessions of BT were 8 (5~10), 5 (3~7) and 3 (1~5), respectively. The median follow-up time was 53 months (range, 9~66 months). The 4-year disease-free survival rate of all patients was 86.8%. Six (8.7%) patients developed pelvic failures, but major late complications developed in only two (2.9%).

Conclusion

Our study shows that effective tumor control, equivalent survival and low rates of major complications can be achieved by modifying the fraction size during BT according to tumor regression, as determined by consecutive MR images. We recommend checking the follow-up MRI at a cumulative BED₁₀ of around 65 Gy to point A, with the initial BT modified at a final booster BT session.

Citations

Citations to this article as recorded by

Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer
Florian Arend, Markus Oechsner, Clara B. Weidenbächer, Stephanie E. Combs, Kai J. Borm, Marciana N. Duma
Tumori Journal.2021; 107(2): 139. CrossRef
Target volume changes through high-dose-rate brachytherapy for cervical cancer when evaluated on high resolution (3.0 Tesla) magnetic resonance imaging
Wenqing Sun, Sudershan K. Bhatia, Geraldine M. Jacobson, Ryan T. Flynn, Yusung Kim
Practical Radiation Oncology.2012; 2(4): e101. CrossRef
Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [18F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography
Mee Sun Yoon, Sung-Ja Ahn, Byung-Sik Nah, Woong-Ki Chung, Ho-Chun Song, Su Woong Yoo, Ju-Young Song, Jae-Uk Jeong, Taek-Keun Nam
International Journal of Radiation Oncology*Biology*Physics.2012; 84(4): e491. CrossRef

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Effects of Interleukin-2 Transduction into the Human Hepatoma Cell Lines Using Retroviral Vector: Soo Jung Gong, Nae Chun Yoo, Joo Hang Kim, Dong Hwan Shin, Hyo Dong Uhm, Sook Jung Jeong, Jae Yong Cho, Sun Young Rha, Yeon Soo Kim, Hyun Cheol Chung, Jae Kyung Roh, Jin Sik Min, Byung Soo Kim; J Korean Cancer Assoc. 1997;29(4):555-564.

Abstract PDF: PURPOSE
We compared the differences between parent hepatoma cell lines and interleukin-2 (IL-2) transduced hepatoma cell lines using N2A/IL-2 and LNC/IL-2 retrovirus with regards to in vitro sensitivity to peripheral blood monocytes and in vivo tumorigenic activity.
MATERIALS AND METHODS
Retroviral vector and producer cell line were constructed and IL-2 gene was transduced into the human hepatoma cell lines (SK-Hep1, Hep-G2, Hep-3B). IL-2 secretion after IL-2 transduction was measured by ELISA. MTT assay for in vitro sensitivity to peripheral blood monocytes was performed and the tumorigenic activity was observed in BALB/c mice and nude mice.
RESULTS
IL-2 secretion was 186 pg/10 degrees C cells/24 hrs in SK-Hep1 cell line and was 147 pg/10 (6) cells/24 hrs in Hep-3B cell line with N2A/IL-2 retroviral vector and was 55,000 pg/10 (6) cells/24 hrs with LNC/IL-2 retroviral vector. In vitro sensitivity to peripheral blood monocytes was increased by 163.8~254% in IL-2 transduced hepatoma cell lines (Hep -3B/N2A/IL-2, Hep-G2/N2A/IL-2) compared to those of the parent cell lines. The tumorigenicity was observed in 1 of 3 BALB/c mice and all 3 nude mice. Simultaneous injection of 1 X 10 (7) cells of the parent cell line (Hep-3B) into the right flank and IL-2 transduced cell line (Hep-3B/LNC/IL-2) into the left flank of the three BALB/c mice and of 5 X 10 (5) cells for the three nude mice resulted in a complete regression of the IL-2 modified tumor cell line (Hep-3B/LNC/IL-2) in 3 weeks and the parent cell line (Hep-3B) in 5 weeks. But, after the injection of 1.5 X 10 (7) cells for other five nude mice, the tumor of the IL-2 transduced hepatoma cell line (Hep-3B/LNC/IL-2) was gradually disappeared, and the tumor of the parent hepatoma cell line (Hep-3B) was initially decreased and then gradually regrew 20 days later.
CONCLUSION
IL-2 transduced hepatoma cell lines secreting IL-2 became more sensitive to peripheral blood monocytes and resulted in the increased antigenicity to the tumors formed by IL-2 transduced hepatoma cell line and parent cell line, and finally resulted in the regression of the tumors in experimental animals.

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