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Structural changes induced by antineoplastic therapies: keys to evaluate tumor response to treatment
F Ferrozzi1, G Tognini, P Pavone
1Institute of Radiological Sciences, University of Parma, via Gramsci 14, 43100 Parma, Italy. ferrozzi@unipr.it
Abstract:
The criteria to define therapeutic response in oncology are those proposed by Miller, characterized by four response categories (complete response, partial response, no change, progression of disease), and based upon both measurable and non-measurable (and otherwise assessable) morphological parameters in comparison with baseline and subsequently modified following the Response Evaluation Criteria In Solid Tumors. In addition to these classical morphological criteria, we review the predictive value of structural changes in the evaluation of response to antineoplastic therapies. The goal of the present review is to evaluate in detail structural variations (calcification, fibrosis, differentiation, necrosis, cavitation, vascularization, edema, and pseudocapsule formation) induced by therapy, and to ascertain their significance in terms of biological evolution of the neoplastic process.
Insights
This review examines structural changes beyond standard criteria to predict cancer treatment effectiveness. Understanding these variations offers deeper insights into tumor response to antineoplastic therapies.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Therapeutic response in oncology traditionally relies on morphological criteria like Response Evaluation Criteria In Solid Tumors (RECIST).
- These criteria assess tumor size and presence/absence of lesions based on measurable and non-measurable parameters.
- However, a comprehensive understanding of treatment impact requires evaluating beyond simple size changes.
Purpose of the Study:
- To review the predictive value of structural changes in evaluating response to antineoplastic therapies.
- To detail specific structural variations induced by therapy, including calcification, fibrosis, differentiation, necrosis, cavitation, vascularization, edema, and pseudocapsule formation.
- To ascertain the significance of these structural variations in the biological evolution of neoplastic processes.
Main Methods:
- Review of existing literature on therapeutic response assessment in solid tumors.
- Analysis of structural changes observed post-antineoplastic therapy.
- Correlation of structural variations with treatment outcomes and tumor biology.
Main Results:
- Structural changes such as calcification, fibrosis, and differentiation can indicate treatment efficacy.
- Necrosis and cavitation may signify tumor cell death and breakdown.
- Vascularization, edema, and pseudocapsule formation provide insights into the tumor microenvironment's response to therapy.
Conclusions:
- Structural variations offer valuable prognostic information beyond classical RECIST criteria.
- Integrating the assessment of these structural changes can enhance the evaluation of therapeutic response in oncology.
- Further research is warranted to standardize the interpretation of these structural markers for improved clinical decision-making.