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Open Access 01-06-2016 | Oncology

Increased tumour ADC value during chemotherapy predicts improved survival in unresectable pancreatic cancer

Authors: Hideyuki Nishiofuku, Toshihiro Tanaka, Nagaaki Marugami, Masayuki Sho, Takahiro Akahori, Yoshiyuki Nakajima, Kimihiko Kichikawa

Published in: European Radiology | Issue 6/2016

Abstract

Objectives

To investigate whether changes to the apparent diffusion coefficient (ADC) of primary tumour in the early period after starting chemotherapy can predict progression-free survival (PFS) or overall survival (OS) in patients with unresectable pancreatic adenocarcinoma.

Methods

Subjects comprised 43 patients with histologically confirmed unresectable pancreatic cancer treated with first-line chemotherapy. Minimum ADC values in primary tumour were measured using the selected area ADC (sADC), which excluded cystic and necrotic areas and vessels, and the whole tumour ADC (wADC), which included whole tumour components. Relative changes in ADC were calculated from baseline to 4 weeks after initiation of chemotherapy. Relationships between ADC and both PFS and OS were modelled by Cox proportional hazards regression.

Results

Median PFS and OS were 6.1 and 11.0 months, respectively. In multivariate analysis, sADC change was the strongest predictor of PFS (hazard ratio (HR), 4.5; 95 % confidence interval (CI), 1.7–11.9; p = 0.002). Multivariate Cox regression analysis for OS revealed sADC change and CRP as independent predictive markers, with sADC change as the strongest predictive biomarker (HR, 6.7; 95 % CI, 2.7–16.6; p = 0.001).

Conclusion

Relative changes in sADC could provide a useful imaging biomarker to predict PFS and OS with chemotherapy for unresectable pancreatic adenocarcinoma.

Key Points

• Relative change in ADC value can predict survival in unresectable pancreatic cancer.

• ADC change could determine a chemosensitivity of pancreatic cancer.

• ADC values should be measured by excluding cystic, necrotic areas and vessels.

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Title: Increased tumour ADC value during chemotherapy predicts improved survival in unresectable pancreatic cancer
Authors: Hideyuki Nishiofuku
Toshihiro Tanaka
Nagaaki Marugami
Masayuki Sho
Takahiro Akahori
Yoshiyuki Nakajima
Kimihiko Kichikawa
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3999-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Increased tumour ADC value during chemotherapy predicts improved survival in unresectable pancreatic cancer

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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