Predictive Value of Optimal Morphologic Response to First-Line Chemotherapy Patients with Colorectal Liver Metastases
Predictive Value of Optimal Morphologic Response to First-Line Chemotherapy Patients with Colorectal Liver Metastases
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DOI：
10.1159/000356218
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发表时间：
2014-01-01
期刊：
影响因子：
3.2
通讯作者：
Sugiyama, Toshiro
中科院分区：
文献类型：
--
作者：
Yoshita, Hiroki;Hosokawa, Ayumu;Sugiyama, Toshiro
背景资料：有报道称，术前化疗的形态学反应是结直肠癌肝转移（CLM）患者行肝切除术的独立预后因素。本研究的目的是评估CLM患者对一线化疗的形态学反应的预测价值。研究方法：我们评估了41例CLM患者，他们在2006年4月至2012年6月期间接受了以氟尿嘧啶为基础的化疗（联合或不联合贝伐单抗）作为一线化疗。三位盲法放射科医生评价计算机断层扫描图像，并根据形态学标准将其分类为最佳、不完全或无反应。根据实体瘤疗效评价标准（RECIST）评价全身化疗的疗效。在多变量分析中确定与无进展生存期（PFS）相关的预测因素。结果：23例患者（56%）接受了贝伐单抗化疗，而18例患者（44%）接受了未接受贝伐单抗化疗。在11例接受贝伐珠单抗治疗的患者（48%）和5例未接受贝伐珠单抗治疗的患者（28%）中观察到最佳形态学缓解（p = 0.19）。8例患者（20%）在化疗后接受了肝切除术。中位随访期为31.3个月。光学形态学缓解患者的中位PFS为13.3个月，不完全/无形态学缓解患者的中位PFS为8.7个月（p = 0.0026）。在多变量分析中，体能状态和形态学缓解是PFS的显著独立预测因素。结论：在以氟尿嘧啶为基础的化疗作为一线化疗的CLM患者中，最佳形态学缓解与PFS显著相关。(C)2014 S. Karger AG，巴塞尔
Background: It has been reported that morphologic response to preoperative chemotherapy is an independent prognostic factor in patients who undergo hepatic resection of colorectal liver metastases (CLM). The aim of this study was to evaluate the predictive value of morphologic response to first-line chemotherapy in patients with CLM. Methods: We assessed 41 patients with CLM who received fluorouracil-based chemotherapy with or without bevacizumab as the first-line chemotherapy between April 2006 and June 2012. Three blinded radiologists evaluated computed tomography images and classified them as optimal, incomplete or no response according to the morphologic criteria. Response to systemic chemotherapy was also evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). Predictive factors associated with progression-free survival (PFS) were identified in multivariate analysis. Results: Twenty-three patients (56%) received chemo-therapy with bevacizumab, while 18 patients (44%) received chemotherapy without bevacizumab. Optimal morphologic response was observed in 11 patients (48%) treated with bevacizumab and in 5 patients (28%) treated without bevacizumab (p = 0.19). Eight patients (20%) underwent hepatic resection after chemotherapy. The median follow-up period was 31.3 months. The median PFS was 13.3 months for patients with optical morphologic response and 8.7 months in those with incomplete/no morphologic response (p = 0.0026). On multivariate analysis, performance status and morphologic response were significant independent predictors of PFS. Conclusion: Optimal morphologic response was significantly associated with PFS in patients with CLM who were treated with fluorouracil-based chemotherapy as the first-line chemotherapy. (C) 2014 S. Karger AG, Basel