New guidelines to evaluate the response to treatment in solid Tumors
New guidelines to evaluate the response to treatment in solid Tumors
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DOI：
10.1093/jnci/92.3.205
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发表时间：
2000-02-02
期刊：
影响因子：
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通讯作者：
Gwyther, SG
中科院分区：
文献类型：
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作者：
Therasse, P;Arbuck, SG;Gwyther, SG
抗癌细胞毒性药物经历了一个过程，通过这个过程，他们的抗肿瘤活性-基于他们可以产生的肿瘤收缩量-已经被研究。20世纪70年代末，国际抗癌联盟和世界卫生组织引入了肿瘤反应评估的具体标准。1994年，参与临床研究的几个组织联合起来，根据自那时以来获得的经验和知识，对这些标准进行了审查。经过几轮密集讨论，一套新的准则已经准备就绪，将取代以前的标准。与此同时，其中一个参与小组开发了一种模型，通过该模型，可以从肿瘤病灶的一维测量而不是通常的二维方法中获得缓解率。这一新概念已在很大程度上得到实体瘤疗效评价标准的验证，并已纳入本指南。这篇特别的文章也提供了一些哲学背景来澄清反应评估的各种目的。它提出了一种模型，通过该模型，对所有现有病变（以靶病变（待测量）和非靶病变为特征）进行综合评估，用于外推治疗的总体反应。评估肿瘤病变的方法更好地编纂，简要地在指南中，更详细地在附录I中。对反应评价的所有其他方面进行了讨论、审查并在适当时进行了修订。
Anticancer cytotoxic agents go through a process by which their antitumor activity-on the basis of the amount of tumor shrinkage they could generate-has been investigated. In the late 1970s, the International Union Against Cancer and the World Health Organization introduced specific criteria for the codification of tumor response evaluation. In 1994, several organizations involved in clinical research combined forces to tackle the review of these criteria on the basis of the experience and knowledge acquired since then. After several gears of intensive discussions, a new set of guidelines is ready that will supersede the former criteria. In parallel to this initiative, one of the participating groups developed a model by which response rates could be derived from unidimensional measurement of tumor lesions instead of the usual bidimensional approach. This new concept has been largely validated by the Response Evaluation Criteria in Solid Tumors Group and integrated into the present guidelines. This special article also provides some philosophic background to clarify the various purposes of response evaluation. It proposes a model by which a combined assessment of all existing lesions, characterized by target lesions (to be measured) and nontarget lesions, is used to extrapolate an overall response to treatment. Methods of assessing tumor lesions are better codified, briefly within the guidelines and in more detail in Appendix I. All other aspects of response evaluation have been discussed, reviewed, and amended whenever appropriate.