Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome

deSouza, Nandita M.; Soutter, W. P.; Rustin, G. J. S.; Mahon, Marrita M.; Jones, Bleddyn; Dina, Roberto; McIndoe, G. Angus

doi:10.1038/sj.bjc.6601870

Cited by 26 publications

(19 citation statements)

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“…105 Some cancers, eg, cervical cancer, did not exhibit a change in the tCho signal following neoadjuvant therapy and subsequent surgical resection of the tumors. 106 However, these cervical cancers displayed a reduced tumor volume along with decreased triglyceride signal, without any difference in patient survival with or without neoadjuvant therapy, and there was no survival advantage associated with the reduced tumor volume or decreased triglycerides. 106 …”

Section: H Mrs Monitoring Of Cancer Therapy: Clinical and Preclinicamentioning

confidence: 87%

“…106 However, these cervical cancers displayed a reduced tumor volume along with decreased triglyceride signal, without any difference in patient survival with or without neoadjuvant therapy, and there was no survival advantage associated with the reduced tumor volume or decreased triglycerides. 106 …”

Section: H Mrs Monitoring Of Cancer Therapy: Clinical and Preclinicamentioning

confidence: 87%

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Metabolic Tumor Imaging Using Magnetic Resonance Spectroscopy

Glunde

Bhujwalla

2011

Seminars in Oncology

117

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The adaptability and the genomic plasticity of cancer cells, and the interaction between the tumor microenvironment and co-opted stromal cells, coupled with the ability of cancer cells to colonize distant organs, contribute to the frequent intractability of cancer. It is becoming increasingly evident that personalized molecular targeting is necessary for the successful treatment of this multifaceted and complex disease. Noninvasive imaging modalities such as magnetic resonance (MR), positron emission tomography (PET), and single-photon emission computed tomography (SPECT) are filling several important niches in this era of targeted molecular medicine, in applications that span from bench to bedside. In this review we focus on noninvasive magnetic resonance spectroscopy (MRS) and spectroscopic imaging (MRSI) and their roles in future personalized medicine in cancer. Diagnosis, the identification of the most effective treatment, monitoring treatment delivery, and response to treatment are some of the broad areas into which MRS techniques can be integrated to improve treatment outcomes. The development of novel probes for molecular imaging—in combination with a slew of functional imaging capabilities—makes MRS techniques, especially in combination with other imaging modalities, valuable in cancer drug discovery and basic cancer research.

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Section: H Mrs Monitoring Of Cancer Therapy: Clinical and Preclinicamentioning

confidence: 87%

Section: H Mrs Monitoring Of Cancer Therapy: Clinical and Preclinicamentioning

confidence: 87%

Metabolic Tumor Imaging Using Magnetic Resonance Spectroscopy

Glunde

Bhujwalla

2011

Seminars in Oncology

117

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“…6 This particular study used MR imaging to monitor tumour volume and MRS to detect changes in molecular profile to assess response and compare the survival with that of a control group. A total of 23 women treated with either radical surgery or chemoradiotherapy treated over the same time period made up the nonrandomised control group.…”

Section: Discussionmentioning

confidence: 99%

In vivo magnetic resonance spectroscopy of gynaecological tumours at 3.0 Tesla

Booth

Pickles

Turnbull

2008

BJOG

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Background Magnetic resonance spectroscopy (MRS) uses the same hardware as MR imaging and allows us to analyse the biochemistry of tissues in vivo. Published data for gynaecological lesions are limited and are largely based on MRS carried out at the lower magnetic field strength of 1.5 Tesla (T).Objective The purpose of this study was to determine whether in vivo proton MRS could be performed at the higher magnetic field strength of 3 T to characterise the spectra of a variety of benign and malignant gynaecological lesions.Design Prospective, non-randomised study.Setting MRI department within a tertiary referral centre for gynaecological cancers.Sample All women with a pelvic mass under going 3T MRI.Methods We carried out MRS on nonrandomised women undergoing routine 3 T MRI within our MRI department during investigation for gynaecological lesions from February 2006 to April 2008. Only those women for whom histopathological data were available were included.Main outcome measures The presence of choline detected by in vivo 3T MRS.Results Eighty-seven women underwent MRS, 57 of whom had newly diagnosed neoplasms. MRS data for 39 of these new women (18 were excluded because of technical errors or missing data) were used to detect the presence of choline, an indicator of basement membrane turnover. Overall, choline was present in 13 of the 14 ovarian cancers, 8 of the 11 cervical tumours and all 4 of the uterine cancers. There was no statistical significant difference between choline levels in various lesion types (P = 0.735) or between benign and malignant disease (P = 0.550).Conclusions In vivo MRS can be performed at 3 T to provide biochemical information on pelvic lesions. The way in which this information can be utilised is less clear but may be incorporated into monitoring tissue response in cancer treatments.

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“…Some scholars believe that neoadjuvant chemotherapy in combination with surgery can enhance long-term survival of the Stage IB2 and IIB patients [14,15] . Others have reported that neoadjuvant chemotherapy can markedly reduce the tumor diameter, but has little significant effect on improvement of the overall survivals and disease-free survivals [16,17] . Certainly, the above-mentioned therapeutic approach remains to be validated by prospective clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for patients with FIGO Stage-IB cervical squamous cell carcinoma: Does the tumor size (≤ 4 cm or > 4 cm) really matter?

Xiong

Liu

Peng

et al. 2007

Chin. J. Clin. Oncol.

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OBJECTIVE To investigate the factors that can accurately predict the prognosis for patients with FIGO stage-IB cervical squamous cell carcinoma treated with radical surgery. METHODS A retrospective analysis of clinical data from 174 cases of FIGO Stage-IB cervical squamous cell carcinoma treated in our institute was conducted. RESULTS The 5-year overall disease-free survival of the patients was 79.4% and the recurrence rate was 16.7%. Seventy-five percent of the 60 patients with a tumor > 4 cm and 28.1% of the 114 patients with a tumor ≤ 4 cm received preoperative radiotherapy, resuting in a significant difference between the two groups (P < 0.001). The 5-year disease-free survival rate for the groups with a tumor ≤ 4 cm without and with preoperative radiotherapy, and with a tumor > 4 cm without and with preoperative radiation therapy were 80.5%, 85.2%, 69.3% and 77.1%, respectively. There was no significant difference between any of the groups (P > 0.05). A univariate analysis showed that pelvic node metastasis, a positive parametrial surgical margin and postoperative adjuvant therapy were all significantly correlated with the 5-year disease-free survivals (P < 0.05). Multivariate analysis revealed that pelvic node metastasis (P = 0.004) and a positive parametrial surgical margin (P = 0.040) were independent factors that influenced the prognosis. The 5-year disease-free survivals for the cases with a tumor ≤ 4 cm and > 4 cm were 57.4% and 44.7% respectively in the high-risk group (patients with pelvic lymphatic metastasis and/or positive parametrial surgical margin) (P=0.575) and the recurrence ratio was 7/18 and 6/14 for the cases of the two tumor sizes in the same risk group. There was no significant difference between the two groups (P=0.821). The 5-year disease-free survivals for the cases with a tumor ≤ 4 cm and > 4 cm were 86.5% and 82.9% respectively in the low-risk group (patients without pelvic lymph-node metastasis and/or positive parametrial surgical margin), respectively (P > 0.05) and the recurrence ratio was 9/95 and 7/47 for the cases of the two tumor sizes in the same risk group. There was no significant difference between the two groups (P > 0.05). CONCLUSIONS For FIGO Stage-IB cervical squamous cell carcinoma patients with radical surgery as the major means of treatment, the features of pelvic lymph-node metastasis and a positive parametrial surgical margin are independent factors that influence the prognosis. The tumor size can not be used as a criterion for predicting the prognosis.In 1995, the standards for staging uterine cervix cancer were revised by the International Federation of Gynecology and Obstetrics [FIGO]. Stage IB was divided into IB1 (≤ 4 cm) and IB2 (> 4 cm), based on the tumor size. According to records from the literature, the overall survival of Stage-IB patients amounted to 90%, whereas the Stage-B2 patients accounted for 65% to 80%

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Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome

Cited by 26 publications

References 28 publications

Metabolic Tumor Imaging Using Magnetic Resonance Spectroscopy

Metabolic Tumor Imaging Using Magnetic Resonance Spectroscopy

In vivo magnetic resonance spectroscopy of gynaecological tumours at 3.0 Tesla

Prognostic factors for patients with FIGO Stage-IB cervical squamous cell carcinoma: Does the tumor size (≤ 4 cm or > 4 cm) really matter?

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