Prognostic significance of carcinoembryonic antigen combined with carbohydrate antigen 19‐9 following neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer

Zheng, Zhifang; Wang, Xiaojie; Lu, Xingrong; Huang, Ying; Chi, Pan

doi:10.1111/codi.15694

“…studies had indicated that various clinical factors could affect the pathological reaction of nCRT in patients with LARC, including the CEA and CA199 level, and clinical staging[26,27]. In our investigation, both univariate and multivariate logistic regression analyses showed that age (P < 0.01) and clinical stage (P < 0.01) could be an independent predictor of good response after nCRT in patients with LARC.…”

supporting

confidence: 47%

Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Qin,

Gan,

Lin

et al. 2023

Preprint

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Objectives To assess the performance of multi-modal ultrasomics model to predict efficacy to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and compare with the clinical model. Materials and methods This study retrospectively included 106 patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 at our hospital, randomly divided into a training set of 74 and a validation set of 32 in a 7: 3 ratios. Ultrasomics features were extracted from the tumors’ region of interest of B-mode ultrasound (BUS) and contrast-enhanced ultrasound (CEUS) images based on PyRadiomics. Mann-Whitney U test, spearman, and least absolute shrinkage and selection operator algorithms were utilized to reduce features dimension. Five models were built with ultrasomics and clinical analysis using multilayer perceptron neural network classifier based on python. Including BUS, CEUS, Combined_1, Combined_2 and Clinical models. The diagnostic performance of models was assessed with the area under the curve (AUC) of the receiver operating characteristic. The DeLong testing algorithm was utilized to compare the models’ overall performance. Results The AUC (95% confidence interval [CI]) of the five models in the validation cohort were as follows: BUS 0.675 (95%CI: 0.481–0.868), CEUS 0.821 (95%CI: 0.660–0.983), Combined_1 0.829 (95%CI: 0.673–0.985), Combined_2 0.893 (95%CI: 0.780-1.000), and Clinical 0.690 (95%CI: 0.509–0.872). The Combined_2 model was the best in the overall prediction performance, showed significantly better compared to the Clinical model after DeLong testing (P < 0.01). Both univariate and multivariate logistic regression analyses showed that age (P < 0.01) and clinical stage (P < 0.01) could be an independent predictor of efficacy after nCRT in patients with LARC. Conclusion The ultrasomics model had better diagnostic performance to predict efficacy to nCRT in patients with LARC than the Clinical model.

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“…Previous studies had indicated that various clinical factors could affect the pathological reaction of nCRT in patients with LARC, including the CEA and CA199 level, and clinical staging [ 27 , 28 ]. In our investigation, both univariate and multivariate logistic regression analyses show that age ( P < 0.01) and clinical stage ( P < 0.01) can be as an independent predictor of good response after nCRT in patients with LARC.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Qin,

Gan,

Lin

et al. 2024

BMC Med Imaging

2

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Objectives To assess the performance of multi-modal ultrasomics model to predict efficacy to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and compare with the clinical model. Materials and methods This study retrospectively included 106 patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 at our hospital, randomly divided into a training set of 74 and a validation set of 32 in a 7: 3 ratios. Ultrasomics features were extracted from the tumors’ region of interest of B-mode ultrasound (BUS) and contrast-enhanced ultrasound (CEUS) images based on PyRadiomics. Mann-Whitney U test, spearman, and least absolute shrinkage and selection operator algorithms were utilized to reduce features dimension. Five models were built with ultrasomics and clinical analysis using multilayer perceptron neural network classifier based on python. Including BUS, CEUS, Combined_1, Combined_2 and Clinical models. The diagnostic performance of models was assessed with the area under the curve (AUC) of the receiver operating characteristic. The DeLong testing algorithm was utilized to compare the models’ overall performance. Results The AUC (95% confidence interval [CI]) of the five models in the validation cohort were as follows: BUS 0.675 (95%CI: 0.481–0.868), CEUS 0.821 (95%CI: 0.660–0.983), Combined_1 0.829 (95%CI: 0.673–0.985), Combined_2 0.893 (95%CI: 0.780-1.000), and Clinical 0.690 (95%CI: 0.509–0.872). The Combined_2 model was the best in the overall prediction performance, showed significantly better compared to the Clinical model after DeLong testing (P < 0.01). Both univariate and multivariate logistic regression analyses showed that age (P < 0.01) and clinical stage (P < 0.01) could be an independent predictor of efficacy after nCRT in patients with LARC. Conclusion The ultrasomics model had better diagnostic performance to predict efficacy to nCRT in patients with LARC than the Clinical model.

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“…However, owing to metastasis to other organs or local recurrence, the long-term survival of LARC is unsatisfactory ( 4 , 17 ). To achieve a better prognosis, imaging ( 39 , 40 ), carcinoembryonic antigen (CEA) combined with carbohydrate antigen 19-9 (CA19-9) ( 41 ), platelet-associated biomarkers ( 42 ), and circulating tumor DNA (ctDNA) ( 43 ) must be dynamically estimated and promptly evaluated. A more personalized treatment regimen is preferable for high risk patients, and novel combination regimens should be further investigated.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of different radiotherapy doses in neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer: A retrospective study

Xu

¹

,

Zou²,

Shao³

et al. 2023

Front. Oncol.

0

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BackgroundThis study aims to compare the efficacy and safety of neoadjuvant chemoradiotherapy (nCRT) with different radiotherapy doses (45Gy and 50.4Gy) in patients with locally advanced rectal cancer (LARC).MethodsHerein, 120 patients with LARC were retrospectively enrolled between January 2016 and June 2021. All patients underwent two courses of induction chemotherapy (XELOX), chemoradiotherapy, and total mesorectum excision (TME). A total of 72 patients received a radiotherapy dose of 50.4 Gy, while 48 patients received a dose of 45 Gy. Surgery was then performed within 5-12 weeks following nCRT.ResultsThere was no statistically significant difference between the baseline characteristics of the two groups. The rate of good pathological response in the 50.4Gy group was 59.72% (43/72), while in the 45Gy group achieved 64.58% (31/48) (P>0.05). The disease control rate (DCR) in the 50.4Gy group was 88.89% (64/72), compared to 89.58% (43/48) in the 45Gy group (P>0.05). The incidence of adverse reactions for radioactive proctitis, myelosuppression, and intestinal obstruction or perforation differed significantly between the two groups (P<0.05). The anal retention rate in the 50.4Gy group was significantly higher in contrast to the 45Gy group (P<0.05).ConclusionsPatients receiving a radiotherapy dose of 50.4Gy have a better anal retention rate but also a higher incidence of adverse events such as radioactive proctitis, myelosuppression, and intestinal obstruction or perforation, and a comparable prognosis to patients treated with a radiotherapy dose of 45Gy.

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Prognostic significance of carcinoembryonic antigen combined with carbohydrate antigen 19‐9 following neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer

Cited by 13 publications

References 29 publications

Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer

Efficacy and safety of different radiotherapy doses in neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer: A retrospective study

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