Tumour growth rate of carcinoma of the colon and rectum: retrospective cohort study

Burke, Joshua; Brown, Peter; Quyn, Aaron; Lambie, Hannah; Tolan, Damian; Sagar, P. M.

doi:10.1002/bjs5.50355

“…This is within the range of measured in vivo (i.e. mean of ≈ 92 [ 51 ] and 150 [ 52 ]days). One previous study [ 51 ] has shown that the of hepatic metastases in patients with CRC may be a useful prognostic marker.…”

Section: Discussionsupporting

confidence: 79%

Towards personalised dosimetry in patients with liver malignancy treated with 90Y-SIRT using in vivo-driven radiobiological parameters

Gholami

¹

,

Willowson

²

,

Bailey

³

2022

EJNMMI Phys

2

0

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Background The prediction of response is one of the major challenges in radiation-based therapies. Although the selection of accurate linear–quadratic model parameters is essential for the estimation of radiation response and treatment outcome, there is a limited knowledge about these radiobiological parameters for liver tumours using radionuclide treatments. Methods The “clinical radiobiological” parameters ($$T_{{\text{p}}}$$ T p , $$T_{{\text{k}}}$$ T k , $$\alpha$$ α , $$\alpha {/}\beta$$ α / β ) for twenty-five patients were derived using the generalised linear–quadratic model, the diagnostic ([18F] FDG PET/CT) and therapeutic ([90Y]-SIR-Spheres PET/CT) images to compute the biological effective dose and tumour control probability (TCP) for each patient. Results It was estimated that the values for $$\alpha$$ α and $$\alpha {/}\beta$$ α / β parameters range in ≈ 0.001–1 Gy−1 and ≈ 1–49 Gy, respectively. We have demonstrated that the time factors, $$T_{{\text{p}}}$$ T p , $$T_{{\text{k}}}$$ T k and $$T_{{{\text{critic}}}}$$ T critic are the key parameters when evaluating liver malignancy lesional response to [90Y]SIR-Spheres treatment. Patients with cholangiocarcinoma have been shown to have the longest average $$T_{{\text{p}}}$$ T p (≈ 236 ± 67 d), highest TCP (≈ 53 ± 17%) and total liver lesion glycolysis response ($$\Delta {\text{TLG}}_{{{\text{liver}}}}$$ Δ TLG liver ≈ 64%), while patients with metastatic colorectal cancer tumours have the shortest average $$T_{{\text{p}}}$$ T p (≈ 129 ± 19 d), lowest TCP (≈ 28 ± 13%) and $$\Delta {\text{TLG}}_{{{\text{liver}}}}$$ Δ TLG liver ≈ 8%, respectively. Conclusions Tumours with shorter $$T_{{\text{k}}}$$ T k have shown a shorter $$T_{{{\text{critic}}}}$$ T critic and thus poorer TCP and $$\Delta {\text{TLG}}_{{{\text{liver}}}}$$ Δ TLG liver . Therefore, these results suggest for such tumours the [90Y]SIR-Spheres will be only effective at higher initial dose rate (e.g. > 50 Gy/day).

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“…However, Pinsky et al [6] reported that the risks of adenoma recurrence according to surveillance intervals (3.4–4.7 years) did not differ significantly between the high- and low-risk groups. Excluding serrated adenoma, it takes 10–20 years for general polyps to develop into colon cancer [27, 28], and the median doubling time for colon cancer is 211 (112–404) days [29].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Effect of Diminutive Adenoma with High-Grade Dysplasia on Surveillance Colonoscopy Interval

Park

¹

,

Kang

²

,

Joo

³

et al. 2021

Dig Dis

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Background Colonoscopy surveillance guidelines set the surveillance schedule based on polyp characteristics. Polyps with high-grade dysplasia (HGD) require 3 years of follow-up regardless of size. However, it is unclear whether patients with diminutive polyps (≤5 mm) with HGD have a higher risk. We evaluated the effect of diminutive adenoma with HGD on adenoma occurrence. Methods From Jan 2015 to Dec 2017, patients who underwent index and surveillance colonoscopy were retrospectively screened. The patients were grouped into no adenoma group, low-risk (patients with ≤2 low-grade dysplasia (LGD)), diminutive HGD and high-risk (HGD >5 mm, ≥3 adenomas) groups according to the index colonoscopy results. Each group was analyzed using logistic analysis. Results The mean follow-up period was 22.47 months. Altogether, 610 (50.45%) patients had LGD and 152 (12.5%) had HGD. Among them, 61(5.0%) patients had a diminutive polyp with HGD. Analysis of the risks of developing advanced adenoma in the surveillance colonoscopy showed that compared to no adenoma group, the diminutive HGD group did not show a significant risk (odds ratio [OR]=1.503 [0.449–5.027], p=0.509), while the high-risk group showed a significant risk (odds ratio [OR]=2.044 [1.015–4.114], p=0.045). Conclusions Diminutive adenoma with HGD increased the risk of adenoma on surveillance colonoscopy, In the case of advanced adenoma, the risk was increased, but it was not statistically significant.

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“…The interquartile range was estimated by multiplying σ by 0.674, and σ was estimated to be 0.0361 months. 18,19 This resulted in a k of 1.95 × 10 −12 months −1 . For lung cancer, approximately 8% of new metastases were detected at 12 months for the tumors considered in this study (ie, those <1 cm in diameter at t = 0).…”

Section: Resultsmentioning

confidence: 99%

Development of a Model to Estimate the Association Between Delay in Cancer Treatment and Local Tumor Control and Risk of Metastases

Ng

¹

,

Stovezky

²

,

Brenner

³

et al. 2021

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IMPORTANCE The coronavirus disease 2019 (COVID-19) pandemic has led to treatment delays for many patients with cancer. While published guidelines provide suggestions on which cases are appropriate for treatment delay, there are no good quantitative estimates on the association of delays with tumor control or risk of new metastases. OBJECTIVES To develop a simplified mathematical model of tumor growth, control, and new metastases for cancers with varying doubling times and metastatic potential and to estimate tumor control probability (TCP) and metastases risk as a function of treatment delay interval. DESIGN, SETTING, AND PARTICIPANTS This decision analytical model describes a quantitative model for 3 tumors (ie, head and neck, colorectal, and non-small cell lung cancers). Using accepted ranges of tumor doubling times and metastatic development from the clinical literature from 2001 to 2020, estimates of tumor growth, TCP, and new metastases were analyzed for various treatment delay intervals. MAIN OUTCOMES AND MEASURES Risk estimates for potential decreases in local TCP and increases in new metastases with each interval of treatment delay. RESULTS For fast-growing head and neck tumors with a 2-month treatment delay, there was an estimated 4.8% (95% CI, 3.4%-6.4%) increase in local tumor control risk and a 0.49% (0.47%-0.51%) increase in new distal metastases risk. A 6-month delay was associated with an estimated 21.3% (13.4-30.4) increase in local tumor control risk and a 6.0% (5.2-6.8) increase in distal metastases risk. For intermediate-growing colorectal tumors, there was a 2.1% (0.7%-3.5%) increase in local tumor control risk and a 2.7% (2.6%-2.8%) increase in distal metastases risk at 2 months and a 7.6% (2.2%-14.2%) increase in local tumor control risk and a 24.7% (21.9%-27.8%) increase in distal metastases risk at 6 months. For slower-growing lung tumors, there was a 1.2% (0.0%-2.8%) increase in local tumor control risk and a 0.19% (0.18%-0.20%) increase in distal metastases risk at 2 months, and a 4.3% (0.0%-10.6%) increase in local tumor control risk and a 1.9% (1.6%-2.2%) increase in distal metastases risk at 6 months. CONCLUSIONS AND RELEVANCE This study proposed a model to quantify the association of treatment delays with local tumor control and risk of new metastases. The detrimental associations were greatest for tumors with faster rates of proliferation and metastasis. The associations were smaller, but still substantial, for slower-growing tumors.

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Tumour growth rate of carcinoma of the colon and rectum: retrospective cohort study

Cited by 18 publications

References 38 publications

Towards personalised dosimetry in patients with liver malignancy treated with 90Y-SIRT using in vivo-driven radiobiological parameters

Towards personalised dosimetry in patients with liver malignancy treated with 90Y-SIRT using in vivo-driven radiobiological parameters

Effect of Diminutive Adenoma with High-Grade Dysplasia on Surveillance Colonoscopy Interval

Development of a Model to Estimate the Association Between Delay in Cancer Treatment and Local Tumor Control and Risk of Metastases

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