Purpose
Perioperative chemotherapy (p-ChT) with FLOT scheme is the gold standard of treatment for locally advanced gastric cancer. However, not all patients benefit from this approach. In this study, we will want to test the performance of CT-Radiomics in the early prediction of response to p-ChT in gastric cancer patients.
Materials
Patients with advanced gastric cancer, studied with contrast enhanced CT at baseline and after p-ChT, will be retrospectively enrolled. Histology of the resected specimen represent the reference standard; patients will be divided into responders (TRG 1a-1b) and non-responders (TRG 2-3) according to Becker tumor regression grade (TRG). Volumetric region of interest of the tumor will be drawn on CT portal-venous phase before and after p-ChT and 120 radiomic features (first and second order) will be extracted. CT-Radiomics performance in predicting response to p-ChT according to TRG, derived from baseline CT-Radiomics alone and delta-Radiomics, will be tested with ROC curve.
Expected results
By extracting CT-Radiomics parameters from pre-treatment CT scans we are expecting to discriminate patient responders from non-responders (p
Conclusion
In conclusion, CT-Radiomics could potentially assume an important supportive role in the radiologic assessment of advanced gastric cancer patients.
The gold standard of treatment in Europe for locally advanced gastric cancer (stage IB-III) is radical gastrectomy with D2 lymphadenectomy and perioperative chemotherapy (p-ChT). However, not all patients are responders and benefit from this approach. In patients who will not respond sufficiently, there is a need for a method to discriminate patients who will benefit from those who will not. In gastric cancer scenario, CT-Radiomics needs to be verified as a potential preoperative prognostic biomarker in gastric cancer; pre-treatment radiomic analysis can potentially provide important information regarding the response rate to perioperative chemotherapy for gastric cancer, thereby improving risk stratification. Therefore, Radiomics may be used as a crucial non-invasive biomarker for the response to perioperative chemotherapy in locally advanced gastric cancer.