Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict survival and response in hepatocellular carcinoma patients treated with sorafenib and metronomic tegafur/uracil
Dynamic contrast-enhanced magnetic resonance imaging biomarkers predict survival and response in hepatocellular carcinoma patients treated with sorafenib and metronomic tegafur/uracil
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DOI：
10.1016/j.jhep.2011.01.032
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发表时间：
2011-10-01
影响因子：
25.7
通讯作者：
Shih, Tiffany Ting-Fang
中科院分区：
文献类型：
--
作者：
Hsu, Chao-Yu;Shen, Ying-Chun;Shih, Tiffany Ting-Fang
背景和目标：索拉非尼联合替加氟/尿嘧啶节拍疗法可诱导晚期肝细胞癌（HCC）患者的肿瘤稳定。本研究评价了动态增强磁共振成像（DCE-MRI）测量的血管反应与临床outcome.Methods的相关性：对接受索拉非尼（800 mg/d）联合替加氟/尿嘧啶（250 mg/m2/d，基于替加氟）治疗的晚期HCC患者在基线和治疗14 d后进行DCE-MRI。一个操作者定义的区域的兴趣被放置在最强烈的增强区域的肿瘤来测量药代动力学参数K-trans. Changes K-transs治疗后的最佳肿瘤反应和survival.Results：31例患者进行了评价。根据实体瘤疗效评价标准（RECIST），1例部分缓解（PR），18例疾病稳定（SD），12例疾病进展（PD）。PR或SD患者的基线K-transs（中位数1215.2 x 10（-3）/min，范围582.5-4555.3 x 10（-3）/min）高于PD患者（中位数702.0 x 10（-3）/min，范围375.2-1938.0 x 10（-3）/min，p = 0.008）。研究治疗14天后，PR或SD患者的中位K-transs变化为-47.1%（范围-87.0至-18.0%），PD患者为9.6%（范围-44.8至+81%）（p < 0.001）。研究治疗14天后，血管反应定义为K-trans 40%或以上的降低，与较长的无进展生存期（中位数29.1 vs. 8.7周，p = 0.033）和总生存期（中位数53.0 vs. 14.9周，p = 0.016）相关。治疗后的K-反式变化的百分比是一个独立的预测肿瘤反应，无进展生存期，和总survival.Conclusions：K-transmased DCE-MRI测量与肿瘤反应和生存期的HCC患者接受索拉非尼加节拍替加氟/尿嘧啶治疗。(C)2011年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background & Aims: Sorafenib plus metronomic tegafur/uracil therapy can induce tumor stabilization in advanced hepatocellular carcinoma (HCC) patients. This study evaluated the correlation of vascular response measured by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the clinical outcome.Methods: DCE-MRI was performed in advanced HCC patients treated with sorafenib (800 mg/d) plus tegafur/uracil (250 mg/m(2)/d based on tegafur) at baseline and after 14 days of treatment. An operator-defined region of interest was placed in the most strongly enhanced area of the tumor to measure the pharmacokinetic parameter K-trans. Changes in K-trans after treatment were correlated with the best tumor response and survival.Results: Thirty-one patients were evaluable. There were one partial response (PR), 18 stable disease (SD), and 12 progressive disease (PD) according to the Response Evaluation Criteria in Solid Tumors (RECIST). Baseline K-trans was higher in patients with PR or SD (median 1215.2 x 10(-3)/min, range 582.5-4555.3 x 10(-3)/min) than patients with PD (median 702.0 x 10(-3)/min, range 375.2-1938.0 x 10(-3)/min, p = 0.008). After 14 days of study treatment, the median K-trans change was -47.1% (range -87.0 to -18.0%) in patients with PR or SD, and 9.6% (range -44.8 to +81%) in those with PD (p < 0.001). A vascular response, defined by a 40% or greater decrease in K-trans after 14 days of study treatment, correlated with longer progression-free survival (median 29.1 vs. 8.7 weeks, p = 0.033) and overall survival (median 53.0 vs. 14.9 weeks, p = 0.016). Percentage of K-trans change after treatment is an independent predictor of tumor response, progression-free survival, and overall survival.Conclusions: K-trans measured by DCE-MRI correlated well with tumor response and survival in HCC patients who received sorafenib plus metronomic tegafur/uracil therapy. (C) 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.