Assessing the Impact of Physical Activity on DCE-MRI and SDF-1/Cry2 Biomarker Predictions of Pathological Response in Rectal Cancer Neoadjuvant Therapy

Abstract

Objective: To investigate whether integrating physical activity with Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) and the biomarkers SDF-1 and Cryptochrome 2 (Cry2) enhances the prediction of complete pathological response in patients with locally advanced rectal cancer undergoing concurrent neoadjuvant chemotherapy.

Methods: This study involved 80 patients treated at our institution from March 2020 to September 2021 with locally advanced rectal cancer. All patients received preoperative neoadjuvant chemotherapy followed by surgery within six to eight weeks. Patients were grouped into those achieving a pathological complete response (pCR; n=27) and those not achieving pCR (n=53). We analyzed the influence of regular, structured physical activity on DCE-MRI parameters and levels of SDF-1 and Cry2. The predictive values of these combined factors were assessed using ROC curves.

Results: Significant differences were observed between the pCR and non-pCR groups in terms of tumor volume reduction and maximum diameter (P<0.05). SDF-1 showed a strong negative correlation with the DCE-MRI parameters Ktrans, Kep, and Ve (R=-0.845, -0.842, -0.813; P<0.05), while Cry2 showed a positive correlation (r=0.856, 0.811, 0.902; P<0.05). Additionally, patients engaging in regular physical activity demonstrated enhanced biomarker profiles and improved DCE-MRI parameters. The combined AUCs for DCE-MRI, Cry2, and SDF-1, indicating the predictive accuracy, were significantly higher than those of any single index, with AUCs of 0.952, 94.16%, and 92.35%, respectively.

Conclusion: The integration of regular physical activity with DCE-MRI and biomarkers SDF-1 and Cry2 significantly improves the predictive accuracy of pathological response in locally advanced rectal cancer patients undergoing neoadjuvant chemotherapy. This approach not only predicts treatment outcomes more effectively but also suggests that physical activity could play a beneficial role in enhancing treatment responsiveness