Neoadjuvant volumetric modulated arc therapy in rectal cancer and the correlation of pathological response with diffusion-weighted MRI and apoptotic markers

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dc.authoridMerdan Fayda / 0000-0002-2800-5327en_US
dc.authorscopusidMerdan Fayda / 6506348846
dc.authorwosidMerdan Fayda / AAF-7370-2019
dc.contributor.authorGürdal, Necla
dc.contributor.authorEmre Merdan Fayda
dc.contributor.authorAlishev, Nijat
dc.contributor.authorBakır, Barış
dc.contributor.authorTaştekin, Didem
dc.contributor.authorAykan, Faruk
dc.contributor.authorGezer, Uğur
dc.contributor.authorBalık, Emre
dc.contributor.authorSağlam, Esra Kaytan
dc.contributor.authorOral, Ethem Nezih
dc.contributor.authorGüllüoğlu, Mine
dc.contributor.authorKizir, Ahmet
dc.date.accessioned2020-08-30T20:07:24Z
dc.date.available2020-08-30T20:07:24Z
dc.date.issued2018
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractPurpose: In this prospective observational study, we aimed to report the applicability and tolerability of neoadjuvant volumetric modulated arc therapy with simultaneous integrated boost (SIB-VMAT) and concurrent chemotherapy in patients with locally advanced rectal cancer (LARC), and to evaluate the correlation of pathological response with apparent diffusion coefficient (ADC) measurements on diffusion-weighted magnetic resonance imaging (DW-MRI) and apoptotic markers. Methods: The study enrolled 30 patients with T3 to T4 and/or N+ rectal cancer who preoperatively received SIB-VMAT and concurrent chemotherapy. Before and after the neoadjuvant treatment, apoptotic markers including the nucleosomes and cell-free DNA fragments in the serum samples were examined; DNA integrity was assessed by amplifying the ACTB gene; and the ADC measurements on the DW-MRI were analyzed. Results: No patients had acute or chronic grade III-IV toxicity. Pathologic complete response (pCR) was achieved in 8 patients (27%), while in 10 patients (33%) near-complete pathological response was obtained. Posttreatment ADC was significantly higher in patients with pCR compared with the others (1.28 vs. 1.10, p = 0.017). ROC curve analysis showed that posttreatment ADC values had a sensitivity of 75% and a specificity of 77.3% for distinguishing the patients with pCR from other responders. On the other hand, posttreatment DNA integrity values were revealed lower than the pretreatment values (p = 0.36). Also, the results revealed an insignificant increase in the posttreatment serum level of nucleosomes (p = 0.72). Conclusions: Neoadjuvant SIB-VMAT with concurrent chemotherapy was proved to be a feasible treatment regimen in LARC with tolerable side effects, and improved local control rate and pCR rate.en_US
dc.identifier.citationGurdal, N., Fayda, M., Alishev, N., Bakir, B., Tastekin, D., Aykan, F., ... & Gulluoglu, M. (2018). Neoadjuvant volumetric modulated arc therapy in rectal cancer and the correlation of pathological response with diffusion-weighted MRI and apoptotic markers. Tumori Journal, 104(4), 266-272.en_US
dc.identifier.doi10.5301/tj.5000702en_US
dc.identifier.endpage272en_US
dc.identifier.issn0300-8916en_US
dc.identifier.issn2038-2529en_US
dc.identifier.issue4en_US
dc.identifier.pmid29218690en_US
dc.identifier.scopus2-s2.0-85054445824en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage266en_US
dc.identifier.urihttps://doi.org/10.5301/tj.5000702
dc.identifier.urihttps://hdl.handle.net/20.500.12713/756
dc.identifier.volume104en_US
dc.identifier.wosWOS:000452303400004en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorFayda, Merdanen_US
dc.language.isoenen_US
dc.publisherSage Publications Ltden_US
dc.relation.ispartofTumori Jen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectApoptotic Markersen_US
dc.subjectDiffusion-Weighted Mrien_US
dc.subjectNucleosomesen_US
dc.subjectPathologic Complete Responseen_US
dc.subjectRectal Carcinomaen_US
dc.subjectVolumetric Modulated Arc Therapy-Simultaneous Integrated Boost (Sib-Vmat)en_US
dc.titleNeoadjuvant volumetric modulated arc therapy in rectal cancer and the correlation of pathological response with diffusion-weighted MRI and apoptotic markersen_US
dc.typeArticleen_US

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