Usefulness of contrast-enhanced ultrasonography in determining treatment efficacy and outcome after pancreatic cancer chemotherapy
Usefulness of contrast-enhanced ultrasonography in determining treatment efficacy and outcome after pancreatic cancer chemotherapy
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DOI：
10.3748/wjg.14.7183
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发表时间：
2008-12-21
影响因子：
4.3
通讯作者：
Moriyasu, Fuminori
中科院分区：
文献类型：
--
作者：
Sofuni, Atsushi;Itoi, Takao;Moriyasu, Fuminori
目的：为了探讨如果对比增强超声检查（CE-US）是有用的，以确定治疗效果和结果在胰腺癌化疗的早期阶段，通过评估肿瘤内的血流动力学变化，使用CE-US与contrast agent.METHODS：受试者是34例不能切除的晚期胰腺癌化疗治疗。结果：第2个疗程结束后，瘤内血流动力学表现为血管丰富（R）组18例，血管贫乏（P）组16例。化疗后血清CA 19 -9水平下降至基线水平一半以下的比例P组为2/15（0.1%），R组为11/16（69%）（P = 0.006）。比较平均化疗疗程数和疗效，P组平均化疗疗程数为4.9平均生存期（MST）为246 d（R组，402天），表明R组的结局明显优于结论：CE-US显示肿瘤内血流变化与血清CA 19 -9水平及预后相关。血清CA 19 -9降低到基线水平的一半以下的患者，以及肿瘤内血流丰富的患者，具有显著更好的结局。因此，CE-US对于评估胰腺癌化疗早期的治疗效果和结局具有潜在的应用价值。(C)2008年，WJG出版社。All rights reserved.
AIM: To investigate if contrast-enhanced ultrasonography (CE-US) is useful for determining treatment efficacy and outcome in the early stages of pancreatic cancer chemotherapy by assessing changes in intratumor hemodynamics using CE-US with a contrast agent.METHODS: The subjects were 34 patients with unresectable advanced pancreatic cancer treated by chemotherapy. CE-US was assessed after every treatment (course) completion under the same conditions, and patients were divided into two groups according to the intratumor enhancement pattern: Vascular rich (R) group and vascular poor (P) group.RESULTS: After the second course of treatment, R group in intratumor hemodynamics had 18 patients, and P group had 16 patients. The reduction rates of serum CA19-9 level after chemotherapy which decreased to half or less of the baseline level were 2/15 (0.1%) in P group, but 11/16 (69%) in R group (P = 0.006). When the mean number of courses of chemotherapy and outcome were compared, P group had a mean number of courses of 4.9 (R group, 10.2) and mean survival time (MST) of 246 d (R group, 402 d), showing that outcome was significantly better in R group (P = 0.006).CONCLUSION: CE-US revealed that the change in intratumor blood flow correlated with both serum CA19-9 level and outcome. Patients with serum CA19-9 that decreased to less than half the baseline level, and patients with an abundant intratumor blood flow, had a significantly better outcome. Thus, CE-US is potentially useful for evaluating treatment efficacy and outcome in the early stages of pancreatic cancer chemotherapy. (C) 2008 The WJG Press. All rights reserved.