Assessing chemotherapy response of squamous cell oesophageal carcinoma with spiral CT
Assessing chemotherapy response of squamous cell oesophageal carcinoma with spiral CT
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DOI：
10.1259/bjr.72.859.10624325
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发表时间：
1999-07-01
影响因子：
2.6
通讯作者：
Metreweli, C
中科院分区：
文献类型：
--
作者：
Griffith, JF;Chan, ACW;Metreweli, C
45 名食管鳞状细胞癌患者在术前化疗前和术后接受了螺旋 CT 检查。食管气态扩张后进行食管CT检查。比较化疗前后的 TNM 分期和 CT 上感知的可切除性，并将其与手术可切除性和病理分期相关。化疗后，26% 的肿瘤 T 期发生变化，9% 的肿瘤 N 期发生变化。化疗后CT预测病理T期的准确度为88%，N期的准确度为84%。化疗前 CT 认为不可切除的 14 个肿瘤中有 6 个在化疗后 CT 上被认为是可切除的。这六个肿瘤中有五个可以通过手术切除。化疗后 CT 预测手术可切除性的准确率为 88%，主要缺陷是低估和高估了气管支气管侵犯。将根据肿瘤体积变化判断的化疗反应的 CT 预测与化疗反应的定量病理评估进行比较。 93% 的食管肿瘤在化疗后体积发生变化，其中 51% 的体积减少大于或等于 50%。然而，连续 CT 检查的肿瘤体积缩小与肿瘤反应的定量病理评估或患者生存率之间没有发现相关性。
45 patients with squamous cell carcinoma of the oesophagus were examined prior to, and following, pre-operative chemotherapy by spiral CT. Oesophageal CT was performed following gaseous distention of the oesophagus. TNM stage and perceived resectability on CT before and after chemotherapy were compared and related to surgical resectability and pathological staging. T-stage changed in 26% and N-stage changed in 9% of tumours after chemotherapy. Post-chemotherapy CT predicted pathological T-stage with an accuracy of 88% and N-stage with an accuracy of 84%. Six of 14 tumours considered irresectable on CT pre-chemotherapy were considered resectable on post-chemotherapy CT. Five of these six tumours were resectable at surgery. Post-chemotherapy CT predicted surgical resectability with an accuracy of 88%, the main pitfall being underestimation and overestimation of tracheobronchial invasion. CT prediction of chemotherapy response as judged by change in tumour volume was compared with a quantitative pathological assessment of chemotherapy response. 93% of oesophageal tumours changed volume after chemotherapy with 51% having a volume reduction of greater than or equal to 50%. However, no correlation was found between tumour volume reduction on serial CT examinations and either a quantitative pathological assessment of tumour response or patient survival.