Three-dimensional Radiologic Assessment of Chemotherapy Response in Ewing Sarcoma Can Be Used to Predict Clinical Outcome
Three-dimensional Radiologic Assessment of Chemotherapy Response in Ewing Sarcoma Can Be Used to Predict Clinical Outcome
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DOI：
10.1148/radiol.2016151301
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发表时间：
2016-09-01
期刊：
影响因子：
19.7
通讯作者：
Daldrup-Link, Heike E.
中科院分区：
文献类型：
--
作者：
Aghighi, Maryam;Boe, Justin;Daldrup-Link, Heike E.
目的：根据儿童肿瘤学小组（COG）标准、实体瘤一维（1D）疗效评价标准（RECIST），比较三维（3D）肿瘤测量结果用于尤文肉瘤治疗反应评估的一致性，和世界卫生组织（WHO）定义的二维（2D）测量以肿瘤体积测量作为参考标准，并确定哪种方法与临床结局最相关。材料和方法：本回顾性研究由三个机构的机构审查委员会批准。74例新诊断尤文肉瘤患者（平均年龄+/-标准差，14.5岁+/- 6.5）在三个医疗中心接受了治疗。根据1D RECIST、2D WHO和3D COG测量，在治疗前后的磁共振图像上评估原发性肿瘤大小。根据RECIST、COG和WHO治疗反应阈值，将肿瘤反应与参考标准（肿瘤体积）进行比较。采用一致性相关、Bland-Altman分析和斯皮尔曼等级相关评估了方法减少百分比测量值之间的一致性。采用Kendall tau和未加权kappa统计量评估治疗反应之间的一致性。采用log-rank检验、Kaplan-Meier曲线和考克斯回归分析比较肿瘤缓解与患者生存率的关系。结果：根据RECIST和COG治疗缓解阈值，3D测量与参考标准的一致性显著优于1D和2D测量（1D、2D和3D测量的一致性相关系数分别为0.41、0.72和0.84; P < .0001）。应答者和非应答者的总生存期比较显示，1D、2D、3D和体积测量的P值分别为0.4133、0.0112、0.0032和0.0027，表明更高维度的测量是总生存期的显著更好的预测因子。根据COG的3D肿瘤测量结果比1D RECIST或2D WHO测量结果更能预测尤文肉瘤的治疗反应，并显示出与临床结局的显著更高相关性。(C)RSNA，2016
Purpose: To compare the agreement of three-dimensional (3D) tumor measurements for therapeutic response assessment of Ewing sarcoma according to the Children's Oncology Group (COG) criteria, one-dimensional (1D) Response Evaluation Criteria in Solid Tumors (RECIST), and two-dimensional (2D) measurements defined by the World Health Organization (WHO) with tumor volume measurements as the standard of reference and to determine which method correlates best with clinical outcomes.Materials and Methods: This retrospective study was approved by the institutional review board of three institutions. Seventy-four patients (mean age +/- standard deviation, 14.5 years +/- 6.5) with newly diagnosed Ewing sarcoma treated at three medical centers were evaluated. Primary tumor size was assessed on pre-and posttreatment magnetic resonance images according to 1D RECIST, 2D WHO, and 3D COG measurements. Tumor responses were compared with the standard of reference (tumor volume) on the basis of RECIST, COG, and WHO therapeutic response thresholds. Agreement between the percentage reduction measurements of the methods was assessed with concordance correlation, Bland-Altman analysis, and Spearman rank correlation. Agreement between therapeutic responses was assessed with Kendall tau and unweighted kappa statistics. Tumor responses were compared with patient survival by using the log-rank test, Kaplan-Meier plots, and Cox regression.Results: Agreement with the reference standard was significantly better for 3D measurement than for 1D and 2D measurements on the basis of RECIST and COG therapeutic response thresholds (concordance correlation of 0.41, 0.72, and 0.84 for 1D, 2D, and 3D measurements, respectively; P < .0001). Comparison of overall survival of responders and nonresponders demonstrated P values of .4133,.0112,.0032, and .0027 for 1D, 2D, 3D, and volume measurements, respectively, indicating that higher dimensional measurements were significantly better predictors of overall survival.Conclusion: The 3D tumor measurements according to COG are better predictors of therapeutic response of Ewing sarcoma than 1D RECIST or 2D WHO measurements and show a significantly higher correlation with clinical outcomes. (C) RSNA, 2016