7/28/2019 BrownCAText - Using MRI to Measure Tumor Sjrinkage Predicts Survival in Adbanced Rectal Cancer

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USING MRI TO MEASURE TUMOR SHRINKAGE PREDICTS SURVIVAL INADVANCED RECTAL CANCER

A new study has shown that for patients with advancedrectal cancer, using magnetic resonance imaging (MRI)

to assess their tumors response to pre-surgerychemotherapy or radiation treatment may predictsurvival. The findings suggest that by using MRI togauge whether a tumor has responded to such

treatments, physicians can use the results to determinewhether to proceed with surgery or to consider othertreatment options for a given patient.

Rectal cancer is commonly detected in advanced stages,and as a result, chemoradiation prior to surgery is

frequently given to try to shrink tumors to make themeasier to operate on. While surgeons attempt tocompletely remove the cancer in order to minimize the

chances of cancer returning, advanced tumors are moredifficult to completely remove and more likely to have

unseen cancer remaining at the edges of tissue at thesurgery site. A positive surgical margin (tumor that

remains at the borders of the surgical resection) isconsidered a strong predictor of local recurrence.

In the study, 111 patients with advanced rectal cancerreceived chemotherapy and/or radiation treatmentbefore undergoing surgery. Using MRI, investigatorsmeasured the cancers response to this treatment, andpatients were classified as good or poor respondersaccording to how much tumor shrinkage there was.Investigators found that 72 percent of good respondersto chemotherapy/radiation were alive after five yearscompared to just over one-fourth (27 percent) of those

who were poor responders, with little tumor shrinkage.

The disease-free survival for those with good responseswas 64 percent versus 31 percent for the poorresponders. In addition, patients whose MRI resultspredicted cancer remaining in the margins after surgery

had a local recurrence rate of 28 percent at five yearscompared to 12 percent for patients with predictedcancer-free tumor margins.

The authors suggest that this use of MRI can aid physiciansin deciding on the best treatment approaches for rectal

cancer. Using MRI prior to surgery could help in themanagement of patients in a number of ways, includingoffering more intense therapy or alternative chemotherapyor changing the surgical plan. Clinical trials may be designe

that can use these MRI evaluations as an initial assessmentof treatment effectiveness.

What this Means for PatientsThis study shows that using imaging, specifically MRI, to reexamine rectal cancer tumors after treatment withchemotherapy and radiation can be helpful to physicians todetermine whether a patient is a candidate for surgery orshould receive other therapies instead of, or prior to,

surgery.

Helpful Links

Guide to Colorectal Cancer:http://www.cancer.net/patient/Cancer+Types/Coloectal+Cancer

MRI What to Expect:http://www.cancer.net/patient/All+About+Cancer/

ancer.Net+Feature+Articles/Cancer+Screening+an+Prevention/Magnetic+Resonance+Imaging+(MRI%26mdash%3BWhat+to+Expect

Understanding Chemotherapy:http://www.cancer.net/patient/All+About+Cancer/ancer.Net+Feature+Articles/Treatments%2C+Test%2C+and+Procedures/Understanding+Chemotherpy

Understanding Radiation Therapy:http://www.cancer.net/patient/All+About+Cancer/ancer.Net+Feature+Articles/Treatments%2C+Test%2C+and+Procedures/Understanding+Radiation+herapy

August 29, 2011

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