Quantitative Ultrasound Evaluation of Tumour Cell Death Response in Locally Advanced Breast Cancer Patients Receiving Chemotherapy
Menée sur 24 patientes recevant une chimiothérapie néoadjuvante pour un cancer du sein de stade localement avancé, cette étude évalue l'intérêt d'une méthode de spectroscopie ultrasonore pour le suivi de la réponse thérapeutique
Purpose: Quantitative ultrasound techniques have been recently demonstrated to be capable of detecting cell death through studies conducted on in vitro, and in vivo models. This study investigates for the first time the potential of early detection of tumour cell death in response to clinical cancer therapy administration in patients, using quantitative ultrasound spectroscopic methods.
Experimental Design: Patients (n=24) with locally advanced breast cancer received neo-adjuvant chemotherapy treatments. Ultrasound data was collected prior to treatment onset and at 4 times during treatment (weeks 1, 4, and 8, and pre-operatively). Quantitative ultrasound parameters were evaluated for clinically responsive and non-responding patients.
Results: Results indicated that quantitative ultrasound parameters demonstrated significant changes for patients who responded to treatment, and no similar alteration was observed in treatment-refractory patients. Such differences between clinically and pathologically determined responding and non-responding patients were statistically significant (p<0.05) after four weeks of chemotherapy. Responding patients demonstrated changes in parameters related to cell death with, on average, an increase in mid-band fit and 0-MHz intercept of 9.1 ± 1.2 dBr and 8.9 ± 1.9 dBr, respectively, whereas spectral slope was invariant. Linear discriminant analysis revealed a sensitivity of 100% and a specificity of 83.3% for distinguishing non-responding patients, by the fourth week into a course of chemotherapy lasting several months.
Conclusions: This study reports for the first time that quantitative ultrasound spectroscopic methods can be applied clinically to evaluate cancer treatment responses, non-invasively. The results form a basis for monitoring chemotherapy effects and facilitating the personalization of cancer treatment.
Clinical Cancer Research , résumé, 2013