Research progress in the use of radiomics for evaluating neoadjuvant chemoradiotherapy efficacy and prognosis in locally advanced rectal cancer

Neoadjuvant chemoradiotherapy (nCRT) before surgery is the standard treatment for locally advanced rectal cancer, yet its effectiveness greatly differs among individuals. Early and accurate assessment of patients’ responses to treatment and prognoses is essential in tailoring treatment plans. Whereas clinical pathological factors and imaging morphological evaluations can provide some insight into treatment responses and the likelihood of recurrence and metastasis, their predictive accuracy remains limited. Radiomics, through extraction of high-dimensional features, enables deep analysis of the intricate structures within tumors and treatment-induced changes, and is increasingly used for the precise evaluation of nCRT effectiveness and prognosis. This article reviews radiomics’ current status and advancements in predicting the efficacy of nCRT and assessing prognosis in patients with locally advanced rectal cancer (LARC).