Evaluation of response to conventional chemotherapy and radiotherapy by perfusion computed tomography in non-small cell lung cancer (NSCLC)

Abstract

Background: To evaluate changes in perfusion computed tomography (PCT) parameters induced by treatment with conventional chemotherapy (CCT) alone or with CCT and radiation therapy (RT) in patients with non-small cell lung cancer (NSCLC) and to determine whether these changes correlate with response as defined by the response evaluation criteria in solid tumours version 1.1 (RECIST-1.1). Methods: Fifty-three patients with a histological diagnosis of NSCLC prospectively underwent PCT of the whole tumour, before/after CCT or before/after CCT and RT. Blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) were compared before and after treatment and with the response as defined by RECIST-1. 1. The relationship between changes in the perfusion parameters and in tumour size was also evaluated. Results: PCT parameters decreased after treatment, significantly for BV (p = 0.002) and MTT (p = 0.027). The 30 patients with partial response had a significant decrease of 21% for BV (p = 0.006) and 17% for MTT (p = 0.031). A non-significant decrease in all perfusion parameters was found in patients with stable disease (p > 0.137). In patients with progressive disease, MTT decreased by 10% (p = 0.465) and the other parameters did not significantly vary (p > 0.809). No significant correlation was found between changes in size and PCT parameters (p > 0.145). Conclusions: Treatment of NSCLC with platinum derivatives, with or without RT, induces changes in PCT parameters. Partial response is associated with a significant decrease in BV and MTT, attributable to the effect of the treatment on tumour vascularisation.

Over-expression of long non-coding RNA ZEB2-AS1 may predict poor prognosis and promote the migration, invasion, and epithelial-mesenchymal transition of tumor cells in non-small cell lung cancer

“…Lung cancer is one of the most lethal cancers in the world 1,2 and its incidence is expected to increase over the next decades. 3 Non-small cell lung cancer (NSCLC) is a common type of lung cancer, accounting for about 80% of all lung cancers.…”

“…3 Non-small cell lung cancer (NSCLC) is a common type of lung cancer, accounting for about 80% of all lung cancers. 1,3 Despite the recent therapeutic advances, the overall 5-year survival rate of NSCLC is less than 10%. 4-6 Hence, it is imperative to investigate novel and helpful approaches to the diagnosis and treatment of patients with NSCLC.…”

Advances in translational imaging of the microcirculation

“…Dynamic contrast enhancement‐CT has also been performed for functional assessment of tumors in the brain, 236 liver, 237 lung, 238 head, and neck 239 . It can provide absolute quantitative indices of tumor blood flow, tumor blood volume, vascular mean transit time, and vascular permeability‐surface area product, which is its main advantage over MRI‐derived relative perfusion indices.…”

“…Researchers have shown the utility of the above functional hemodynamic parameters in assessing the response to various anti‐tumor therapies (Figure 7). 238,240 Moreover, CT imaging has been employed for intraoperative visualization of the tumor feeder vasculature as small as 200 µm in diameter during transcatheter arterial chemoembolization (TACE) treatment. This enabled a means to improve drug delivery in patients with hepatocellular carcinoma 241 .…”

“…Treatment‐induced vascular changes in this tumor included an average decrease of 15% in BV (ml/100 ml) (A, C, D, F), 36% in MTT (seconds) (B, C, E, F), 13% in PMB (ml/100 ml/min) (C, F) and an increase of 41% in BF (ml/100 ml/min) (C, F). Reproduced with permission from 238 …”