Early evaluation of liver metastasis using spectral CT to predict outcome in patients with colorectal cancer treated with FOLFOXIRI and bevacizumab

• Published in: Cancer imaging 2023-03, Vol.23 (1), p.30-30, Article 30
• Main Authors: Li, Shenglin, Yuan, Long, Yue, Mengying, Xu, Yuan, Liu, Suwei, Wang, Feng, Liu, Xiaoqin, Wang, Fengyan, Deng, Juan, Sun, Qiu, Liu, Xianwang, Xue, Caiqiang, Lu, Ting, Zhang, Wenjuan, Zhou, Junlin
• Format: Article
• Language: English
• Subjects: Abdomen; Analysis; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab; Bevacizumab - therapeutic use; Biomarkers; Cancer; Cancer therapies; Chemotherapy; Clinical medicine; Colorectal cancer; Colorectal Neoplasms - pathology; Computed tomography; CT imaging; Efficacy evaluation; Evaluation; Fluorouracil; FOLFOXIRI; Growth factors; Hospitals; Humans; Iodine; Leucovorin; Liver; Liver metastasis; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Male; Medical imaging; Medical prognosis; Medical research; Medicine, Experimental; Metastasis; Morphology; Multivariate analysis; Neoplasm Metastasis - drug therapy; Parameters; Patient outcomes; Patients; Prognosis; Retrospective Studies; Risk factors; Spectral CT; Tomography; Tomography, X-Ray Computed - methods; Tumors
• ISSN: 1470-7330; 1740-5025; 1470-7330
• DOI: 10.1186/s40644-023-00547-w

Early evaluation of the efficacy of first-line chemotherapy combined with bevacizumab in patients with colorectal cancer liver metastasis (CRLM) remains challenging. This study used 2-month post-chemotherapy spectral computed tomography (CT) to predict the overall survival (OS) and response of CRLM patients with bevacizumab-containing therapy. This retrospective analysis was performed in 104 patients with pathologically confirmed CRLM between April 2017 and October 2021. Patients were treated with 5-fluorouracil, leucovorin, oxaliplatin or irinotecan with bevacizumab. Portal venous phase spectral CT was performed on the target liver lesion within 2 months of commencing chemotherapy to demonstrate the iodine concentration (IoD) of the target liver lesion. The patients were classified as responders (R +) or non-responders (R -) according to the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at 6 months. Multivariate analysis was performed to determine the relationships of the spectral CT parameters, tumor markers, morphology of target lesions with OS and response. The differences in portal venous phase spectral CT parameters between the R + and R - groups were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the predictive power of spectral CT parameters. Of the 104 patients (mean age ± standard deviation: 57.73 years ± 12.56; 60 men) evaluated, 28 (26.9%) were classified as R + . Cox multivariate analysis identified the iodine concentration (hazard ratio [HR]: 1.238; 95% confidence interval [95% CI]: 1.089-1.408; P