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Defining response to radiotherapy in rectal cancer using magnetic resonance imaging and histopathological scales

World Journal of Gastroenterology 2016年第37期22卷 8414-8434页

作者： Muhammed RS Siddiqui jemma Bhoday nicholas J Battersby Manish Chand nicholas P West Al-Mutaz Abulafi Paris P Tekkis Gina Brown Department of Colorectal Surgery Croydon University Hospital Croydon London CR7 7YE United Kingdom Department of Radiology Royal Marsden Hospital Sutton SM2 5PT United Kingdom Pathology and Tumour Biology Leeds Institute of Cancer and Pathology St. James's University Hospital Leeds LS9 7TF United Kingdom Department of Surgery Royal Marsden Hospital Fulham Rd London SM2 5PT United Kingdom

AIM To define good and poor regression using pathology and magnetic resonance imaging(MRI) regression scales after neo-adjuvant chemotherapy for rectal *** A systematic review was performed on all studies up to December 2015, without language restriction, t h a t w e r e i d e n t i f i e d f r o m M E D L I n E, C o c h r a n e Controlled Trials Register(1960-2015), and EMBASE(1991-2015). Searches were performed of article bibliographies and conference abstracts. MeS H and text words used included "tumour regression", "mr TRG", "poor response" and "colorectal cancers". Clinical studies using either MRI or histopathological tumour regression grade(TRG) scales to define good and poor responders were included in relation to outcomes [local recurrence(LR), distant recurrence(DR), disease-free survival(DFS), and overall survival(OS)]. There was no age restriction or stage of cancer restriction for patient inclusion. Data were extracted by two authors working independently and using pre-defined outcome *** Quantitative data(prevalence) were extracted and analysed according to meta-analytical techniques using comprehensive meta-analysis. Qualitative data(LR, DR, DFS and OS) were presented as ranges. The overall proportion of poor responders after neo-adjuvant chemoradiotherapy(CRT) was 37.7%(95%CI: 30.1-45.8). There were 19 different reported histopathological scales and one MRI regression scale(mrT RG). Clinical studies used nine and six histopathological scales for poor and good responders, respectively. All studies using MRI to define good and poor response used one scale. The most common histopathological definition for good response was the Mandard grades 1 and 2 or Dworak grades 3 and 4; Mandard 3, 4 and 5 and Dworak 0, 1 and 2 were used for poor response. For histopathological grades, the 5-year outcomes for poor responders were LR 3.4%-4.3%, DR 14.3%-20.3%, DFS 61.7%-68.1% and OS 60.7-69.1. Good pathological response 5-year outcomes were LR

关键词： Tumour regression mrT RG Poor response neo-adjuvant therapy Rectal cancer

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