title: Effects of platinum/taxane based chemotherapy on acute perfusion in human pelvic tumours measured by dynamic MRI.
abstract: Dynamic contrast enhanced MRI (DCE-MRI) is being used increasingly in clinical trials to demonstrate that vascular disruptive and antiangiogenic agents target tumour microcirculation. Significant reductions in DCE-MRI kinetic parameters are seen within 4-24 and 48 h of treatment with vascular disruptive and antiangiogenic agents, respectively. It is important to know whether cytotoxic agents also cause significant acute reductions in these parameters, for reliable interpretation of results. This study investigated changes in transfer constant (K(trans)) and the initial area under the gadolinium curve (IAUGC) following the first dose of chemotherapy in patients with mostly gynaecological tumours. A reproducibility analysis on 20 patients (using two scans performed on consecutive days) was used to determine the significance of DCE-MRI parameter changes 24 h after chemotherapy in 18 patients. In 11 patients who received platinum alone or with a taxane, there were no significant changes in K(trans) or IAUGC in either group or individual patient analyses. When the remaining seven patients (treated with a variety of agents including platinum and taxanes) were included (n=18), there were also no significant changes in K(trans). Therefore, if combination therapy does show changes in DCE-MRI parameters then the effects can be attributed to antivascular therapy rather than chemotherapy.
authors.affiliation: Department of Medical Oncology, Mount Vernon Hospital, Rickmansworth Rd, Northwood, Middlesex HA6 2RN, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Lankester
authors.forename: N J
authors.initials: NJ
authors.lastname: Taylor
authors.forename: J J
authors.initials: JJ
authors.lastname: Stirling
authors.forename: J
authors.initials: J
authors.lastname: Boxall
authors.forename: J A
authors.initials: JA
authors.lastname: D'Arcy
authors.forename: M O
authors.initials: MO
authors.lastname: Leach
authors.forename: G J S
authors.initials: GJ
authors.lastname: Rustin
authors.forename: A R
authors.initials: AR
authors.lastname: Padhani
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000188:drug therapy; D010386:Pelvic Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000188:drug therapy; D010534:Peritoneal Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000188:drug therapy; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D001952:Bridged-Ring Compounds; D003287:Contrast Media; D009944:Organoplatinum Compounds; D043823:Taxoids; C080625:taxane