Abstract:

Introduction: although great progress has been made in the diagnosis and treatment of oncological diseases, malignant tumors still remain among the leading death causes globally. Thus, improving diagnostic methods, as well as predicting response to cancer treatment is a relevant clinical medicine problem.

Aim: was to study the role of radiomics and radiogenomics in the diagnosis, clinical prognosis and treatment response assessment in oncological diseases on the basis of available scientific information sources.

Material and methods: analysis of 55 domestic and foreign literature sources. Images obtained by the methods of diagnostic radiology (CT, MRI, PET) represent the phenotypic manifestation substrate of malignant tumors and can be correlated with the expression profiles of certain genes.

Malignant tumors radiomics and radiogenomics involves the search for correlations of visualization quantitative signs with a genomic signature using computer algorithms for data analysis. The ultimate goal of this process is to establish a link between imaging features, tumor molecular genetic characteristics and treatment response assessment.

Conclusion: numerous studies illustrate the possibility of involving radiomics and radiogenomics in all stages of oncological care, from diagnosis to therapeutic response evaluation and relapse risk assessment in a particular patient, which contributes to a personalized approach in oncology and clinical decision-making system implementation.

Abstract:

Aim: was to proceed comparative analysis of immediate and long-term results of chemoradiation treatment of unresectable local-spread oropharyngeal cancer with use of standart chemoradiatior therapy with intravenous chemoinjection and individual volume-controlled superselective intraarterial chemotherapy.

Materials and methods: 43 patients with unresectable oropharyngeal cancer were included in trial comparing intra-arterial (IA) and intravenous (IV) chemoradiation. IV chemoradiation (n=19 patients) comprised 3-4 times of 100 mg/m2 cisplatin infusion on days 1, 22, 43 combined 2Gy x 5 days fractions with total radiation dose 72Gy The IA chemoradiation group (n=24) comprised 3 or 4 x 90 mg/m2 cisplatin administered in the tumor-feeding artery by personified volume- controlled targeted perfusion. The induction IA chemotherapy was given one day before radiation. Then IA chemotherapy conducted regularly 22, 43, 64 days followed radiation.

Results: we made 86 IA procedures and had no IA-related death or procedure related complications. Five patients of IA group were excluded from long term analysis because of non-comleted protocol. The median follow-up was 21±2.3 months in IA group and 36 months in all patients in IV therapy group. In 19 patients received IA chemoradiotherapy protocol - 100% complete response (CR) and in IV chemoradiotherapy - only in 10 (53%) of 19 patients (ф = 6,820, р<0.05). CR was noted in 8 patients with N1 lymph-nodes and in 9 of 10 patients with N2 lymph nodes in IA therapy group. Initial lymph nodes regress more than 80-90% was observed and follow up improvement was confirmed by PET-CT. One-year overall survival (OS) rates were 95% and 79%, respectively in IA and IV groups (not significant OR = 4,8; ф = 1,51; р = 0,05), but two year OS rates were 90% and 58%, respectively (р<0,05). These data are encourage but further follow-up results need to be investigated. 

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