Measurability of non-small-cell lung cancer on chest radiographs.
Measurability of non-small-cell lung cancer on chest radiographs.
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胸片上非小细胞肺癌的可测量性。
DOI：
10.1200/jco.1986.4.8.1184
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
H. Kreisman
中科院分区：
文献类型：
--
作者：
S. Herschorn;J. Hanley;N. Wolkove;C. Cohen;H. Frank;M. Palayew;H. Kreisman
在多中心试验中，通过治疗前后肿瘤尺寸的放射测量来确定对各种药物方案的反应率。测量病变的方式可能会影响报告的结果。原发性肺癌引起的病变可能比圆形周围转移更难以评估。以前没有研究评估原发性肺癌患者肿瘤测量的可变性。12例非小细胞肺癌（NSCLC）患者的19张x线片在两个不同的场合展示给25位有经验的读者。治疗前和治疗后（化疗和放疗联合）的x线片首先分开显示，未识别且顺序随机。三个月后，他们与设备并排展示以进行比较。肿瘤缩小大于或等于50%被认为是一种“反应”。与单独阅读每一对x线片相比，一起观看成对的x线片增加了观看者测量肿瘤的能力。51%的无法测量的配对在一起阅读时变得可测量，而13%的以前可测量的配对现在变得不可测量。测量结果的观察者间变异为10%至265%，而观察者内变异为4%至10%。根据第一次和第二次读数计算出的答案之间的相关性通常并不比单凭运气好。主观印象的改善程度与客观测量的反应率没有很好的相关性。由于测量结果的差异很大，因此反应率也有很大差异，我们建议任何特定研究的所有x光片都由一个观察者审查，治疗前和治疗后的x光片一起评估。
Response rates to various drug regimens are determined in multi-center trials by radiographic measurement of tumor dimensions before and after treatment. The way in which lesions are measured may affect the reported results. Lesions due to primary lung cancer may be more difficult to assess than rounded peripheral metastases. No previous study has assessed the variability of tumor measurements in patients with primary lung cancer. Nineteen radiographs from 12 patients with non-small-cell lung cancer (NSCLC) were shown to 25 experienced readers on two separate occasions. Pre- and post-treatment (combined chemotherapy and radiotherapy) radiographs were first shown separately, unidentified and in random order. Three months later, they were shown side by side with the facility for comparison. A decrease in tumor size of greater than or equal to 50% was considered as a "response." Viewing paired films together increased the viewers ability to measure tumors compared with reading each film of the radiographic pair individually. Fifty-one percent of unmeasurable pairs became measurable when read together, whereas 13% of previously measurable pairs now became unmeasurable. The interobserver variation in measurements was 10% to 265%, while the intraobserver variation was 4% to 10%. The correlation between responses calculated on the first and second readings often was no better than chance alone. Subjective impressions of degree of improvement showed no good correlation with response rates measured objectively. Because of the large variation in measurements and consequently in response rate, we recommend that all radiographs be reviewed by a single observer for any particular study, and pre- and post-treatment radiographs be evaluated together.