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Title: Change in the Growth Rate of Localized Pancreatic Adenocarcinoma in Response to Gemcitabine, Bevacizumab, and Radiation Therapy on MDCT

Abstract

Purpose: To depict treatment response to chemoradiotherapy by comparing tumor growth rate between treated and untreated patients and to compare depicted response with objective response according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 guideline. Methods and Materials: This Health Insurance Portability and Accountability Act-compliant, retrospective study was approved by the institutional review board. Volume doubling time (DT) of histologically confirmed locally advanced pancreatic adenocarcinoma was calculated in 16 patients treated with chemoradiotherapy and 10 untreated patients by incorporating interscan interval ({Delta}t) and tumor volume at baseline (V0) and follow-up (V1) obtained by semiautomated segmentation into the following equation: DT = {Delta}t . log 2/log (V1/V0). Reciprocal of doubling time (RDT), which is the linear representation of tumor growth rate, was calculated by use of the following equation: RDT = 365/DT. The lowest RDT value of 2.42 in untreated patients was considered as the cutoff value for depiction of treatment response. Depicted response rate was defined as the proportion of patients with an RDT value of less than 2.42. Depicted response was compared with objective response according to the RECIST 1.1 guideline. The significance level was set at p < 0.05. Results: There was a significant difference inmore » mean RDT between treated (range, -7.12 to 3.27; mean, -1.27; median, -1.30) and untreated (range, 2.42 to 10.74; mean, 5.33; median, 4.26) patients (p < 0.05). Reciprocal of doubling time was less than 2.42 in 14 treated patients, which corresponded to a depicted response rate of 87.50% as opposed to the objective response rate of 18.75% according to the RECIST 1.1 guideline (p < 0.05) and carbohydrate antigen 19-9 response rate of 62.50% (p > 0.05). Carbohydrate antigen 19-9 response was concordant with RDT and RECIST response in 12 patients (75.00%) ({kappa}, 0.38) and 9 patients (56.25%) ({kappa}, 0.24), respectively. Conclusions: There was a significant difference between depicted response according to RDT and objective response according to RECIST. Reciprocal of doubling time might serve as a valuable biomarker for evaluation of treatment response when depiction of small changes in tumor size is concerned.« less

Authors:
; ; ; ;  [1];  [2];  [1];  [3]
  1. Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL (United States)
  2. Department of Medicine, Division of Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL (United States)
  3. (United States)
Publication Date:
OSTI Identifier:
21587733
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 81; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2010.05.060; PII: S0360-3016(10)00808-4; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTIGENS; BIOLOGICAL MARKERS; CARCINOMAS; COMBINED THERAPY; EQUATIONS; PANCREAS; RADIOTHERAPY; BODY; DIGESTIVE SYSTEM; DISEASES; ENDOCRINE GLANDS; GLANDS; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY

Citation Formats

Rezai, Pedram, Yaghmai, Vahid, Tochetto, Sandra M., Galizia, Mauricio S., Miller, Frank H., Mulcahy, Mary F., Small, William, E-mail: WSmall@nmff.org, and Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northwestern Memorial Hospital/Galter Pavilion, Chicago, IL. Change in the Growth Rate of Localized Pancreatic Adenocarcinoma in Response to Gemcitabine, Bevacizumab, and Radiation Therapy on MDCT. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.05.060.
Rezai, Pedram, Yaghmai, Vahid, Tochetto, Sandra M., Galizia, Mauricio S., Miller, Frank H., Mulcahy, Mary F., Small, William, E-mail: WSmall@nmff.org, & Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northwestern Memorial Hospital/Galter Pavilion, Chicago, IL. Change in the Growth Rate of Localized Pancreatic Adenocarcinoma in Response to Gemcitabine, Bevacizumab, and Radiation Therapy on MDCT. United States. doi:10.1016/j.ijrobp.2010.05.060.
Rezai, Pedram, Yaghmai, Vahid, Tochetto, Sandra M., Galizia, Mauricio S., Miller, Frank H., Mulcahy, Mary F., Small, William, E-mail: WSmall@nmff.org, and Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northwestern Memorial Hospital/Galter Pavilion, Chicago, IL. Sat . "Change in the Growth Rate of Localized Pancreatic Adenocarcinoma in Response to Gemcitabine, Bevacizumab, and Radiation Therapy on MDCT". United States. doi:10.1016/j.ijrobp.2010.05.060.
@article{osti_21587733,
title = {Change in the Growth Rate of Localized Pancreatic Adenocarcinoma in Response to Gemcitabine, Bevacizumab, and Radiation Therapy on MDCT},
author = {Rezai, Pedram and Yaghmai, Vahid and Tochetto, Sandra M. and Galizia, Mauricio S. and Miller, Frank H. and Mulcahy, Mary F. and Small, William, E-mail: WSmall@nmff.org and Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northwestern Memorial Hospital/Galter Pavilion, Chicago, IL},
abstractNote = {Purpose: To depict treatment response to chemoradiotherapy by comparing tumor growth rate between treated and untreated patients and to compare depicted response with objective response according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 guideline. Methods and Materials: This Health Insurance Portability and Accountability Act-compliant, retrospective study was approved by the institutional review board. Volume doubling time (DT) of histologically confirmed locally advanced pancreatic adenocarcinoma was calculated in 16 patients treated with chemoradiotherapy and 10 untreated patients by incorporating interscan interval ({Delta}t) and tumor volume at baseline (V0) and follow-up (V1) obtained by semiautomated segmentation into the following equation: DT = {Delta}t . log 2/log (V1/V0). Reciprocal of doubling time (RDT), which is the linear representation of tumor growth rate, was calculated by use of the following equation: RDT = 365/DT. The lowest RDT value of 2.42 in untreated patients was considered as the cutoff value for depiction of treatment response. Depicted response rate was defined as the proportion of patients with an RDT value of less than 2.42. Depicted response was compared with objective response according to the RECIST 1.1 guideline. The significance level was set at p < 0.05. Results: There was a significant difference in mean RDT between treated (range, -7.12 to 3.27; mean, -1.27; median, -1.30) and untreated (range, 2.42 to 10.74; mean, 5.33; median, 4.26) patients (p < 0.05). Reciprocal of doubling time was less than 2.42 in 14 treated patients, which corresponded to a depicted response rate of 87.50% as opposed to the objective response rate of 18.75% according to the RECIST 1.1 guideline (p < 0.05) and carbohydrate antigen 19-9 response rate of 62.50% (p > 0.05). Carbohydrate antigen 19-9 response was concordant with RDT and RECIST response in 12 patients (75.00%) ({kappa}, 0.38) and 9 patients (56.25%) ({kappa}, 0.24), respectively. Conclusions: There was a significant difference between depicted response according to RDT and objective response according to RECIST. Reciprocal of doubling time might serve as a valuable biomarker for evaluation of treatment response when depiction of small changes in tumor size is concerned.},
doi = {10.1016/j.ijrobp.2010.05.060},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 81,
place = {United States},
year = {2011},
month = {10}
}