MRI scans help predict best treatment for rectal cancer

In collaboration with the Press Association

Patients with advanced rectal cancer can be given the most appropriate follow-up treatment if they are given an MRI scan before they have surgery, a UK study published in the Journal of Clinical Oncology has suggested.

People with advanced rectal cancer often receive chemotherapy or radiotherapy to shrink the tumours before they are surgically removed.

Scientists running the MERCURY research programme found that using MRI to measure how well a patient's tumour has responded to such treatment helps predict how long that patient will survive following surgery.

In the study, 111 patients received pre-surgery chemotherapy or radiotherapy, with MRI used to measure their level of response to the treatments before they had surgery.

Patient responses were classed as 'good' or 'poor', depending on how much their tumour had shrunk by.

After five years, researchers found that 72 per cent of participants who were classified as having 'good' response using MRI were still alive.

In comparison, 27 per cent of those classified as having a 'poor' response were still alive after five years.

Lead author, Dr Gina Brown, consultant radiologist at The Royal Marsden Hospital NHS Foundation Trust, said: "This is the first time that MRI has been shown to predict outcome for patients with rectal cancer who have completed initial chemoradiation therapy.

"We've shown that using MRI this way can help change the course of patient care, perhaps enabling physicians to choose a more effective chemotherapy drug or even in some cases avoid surgery."

Professor Dion Morton, a Cancer Research UK bowel cancer expert, said: "This is a field where the UK is a world leader. Studies carried out in this country are already shaping how patients with rectal cancer are treated. This research takes us a step further and suggests that preoperative MRI scans can help doctors choose the most suitable treatment for their patients. This would give doctors the opportunity to modify a patient's treatment, potentially delaying surgery for people who don't respond to their initial treatment and finding other treatments that work.

"The next step is to research what the best treatment approach is for 'good' and 'poor' responders. Exploring these findings in further studies should be a priority, as they will lead to better outcomes and quality of life for rectal cancer patients."

Copyright Press Association 2011

References

  • Patel, U. B. et al. Magnetic Resonance Imaging–Detected Tumor Response for Locally Advanced Rectal Cancer Predicts Survival Outcomes: MERCURY Experience. J Clin Oncol DOI:10.1200/JCO.2011.34.9068