基于MRI的形态特征作为局部先进的直肠癌中临床结果的预测者,使用新辅助化学放射治疗:来自单一机构经验的见解
Marco Lucarelli1, Consuelo Rosa2, Giulia de Pasquale2
1Division of Radiation Oncology, European Institute of Oncology IRCSS, 20141 Milan, Italy.
Journal of clinical medicine
|January 28, 2026
概括
瘤延伸,边缘状况和淋巴结参与等MRI特征预测化学放射治疗 (CRT) 后局部晚期直肠癌 (LARC) 患者的结果. 这些成像生物标志物有助于风险分层和个性化治疗规划.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 局部晚期直肠癌 (LARC) 需要多模式治疗,通常涉及新辅助化学放射治疗 (CRT).
- 预测LARC患者的长期结果对于治疗优化至关重要.
- 磁力共振成像是评估直肠癌分期和治疗反应的关键成像方法.
研究的目的:
- 评估基于MRI的形态特征作为LARC患者治疗新辅助CRT的长期临床结果的预测因素.
- 在MRI上识别与生存和局部控制相关的特定成像生物标志物.
主要方法:
- 对134名LARC患者进行了回顾性分析,这些患者接受了剂量强化的放射治疗 (55 Gy) 和capecitabine,随后进行了手术.
- 对CRT前后的MRI扫描进行分析,包括瘤扩展超出肌肉本身 (TEMP),周围切除边缘 (CRM),外围静脉入侵 (EMVI) 和侧侧淋巴结 (LLN) 等特征.
主要成果:
- 五年总生存率 (OS),无病生存率 (DFS) 和局部控制率 (LC) 分别为85%,83%和88%.
- TEMP>5毫米,阳性CRM (<1毫米),EMVI和持续的病理LLN显著与LC和/或DFS的恶化有关.
- 显著发现的p值在0.01到0.04之间.
结论:
- 像TEMP>5毫米,CRM<1毫米,EMVI和病态LLN等MRI形态特征是LARC中较差瘤结果的显著预测因素.
- 这些成像生物标志物使得LARC患者的风险分层更好.
- 识别这些MRI特征可以为LARC提供个性化的治疗策略.
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