Locally advanced gastric cancer: total iodine uptake to predict the response of primary lesion to neoadjuvant chemotherapy
Locally advanced gastric cancer: total iodine uptake to predict the response of primary lesion to neoadjuvant chemotherapy
复制标题
局部晚期胃癌：总碘摄入量预测原发灶对新辅助化疗的反应
DOI：
10.1007/s00432-018-2728-z
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发表时间：
2018-11-01
影响因子：
3.6
通讯作者：
Zhang, Huan
中科院分区：
文献类型：
--
作者：
Gao, Xiaoyuan;Zhang, Yang;Zhang, Huan
目的新辅助化疗的病理反应是许多癌症类型的预后因素。然而，现有的评价标准是有缺陷的。我们试图前瞻性地评估来自双能量计算机断层扫描（DECT）的总碘摄取量在预测治疗效果和无进展生存期（PFS）时间在胃癌新辅助化疗后，从2012年10月至2015年12月，44例局部晚期胃癌患者进行了检查，新辅助化疗前1周和3个周期后的DECT。计算肿瘤面积（%ΔS）、直径（%ΔD）和密度（%ΔHU）的百分比变化，以评价WHO、RECIST和Choi标准。计算肿瘤体积变化百分比（%ΔV）和门脉期总摄碘量（%ΔTIU-p），以确定ROC曲线的截断值。结果44例患者根据体积减少43.34%（P= 0.002）和TIU-p减少63.87%（P = 0.002）分为应答者和无应答者。%ΔTIU-p呈强相关（r= 0.602，P = 0.000），%Δ V呈中度相关（r= 0.416，P = 0.005），WHO（r= 0.075，P = 0.627）、RECIST（r= 0.270，P = 0.077）和Choi标准（r= 0.238，P = 0.120）与Becker评分无相关性。根据%ΔTIU-p和Choi标准，有效率组和无效率组的PFS时间差异有统计学意义（分别为P= 0.001和P = 0.013）。此外，%ΔTIU-p可能是PFS时间的潜在有价值的预测参数之一。
PurposePathologic response to neoadjuvant chemotherapy is a prognostic factor in many cancer types. However, the existing evaluative criteria are deficient. We sought to prospectively evaluate the total iodine uptake derived from dual-energy computed tomography (DECT) in predicting treatment efficacy and progression-free survival (PFS) time in gastric cancer after neoadjuvant chemotherapy.MethodsFrom October 2012 to December 2015, 44 patients with locally advanced gastric cancer were examined with DECT 1 week before and three cycles after neoadjuvant chemotherapy. The percentage changes in tumor area (%ΔS), diameter (%ΔD), and density (%ΔHU) were calculated to evaluate the WHO, RESCIST, and Choi criteria. The percentage changes in tumor volume (%ΔV) and total iodine uptake of portal phase (%ΔTIU-p) were also calculated to determine cut-off values by ROC curves. The correlation between the different criteria and histopathologic tumor regression grade (Becker score) or PFS were statistically analyzed.ResultsForty-four patients were divided into responders and non-responders according to 43.34% volume reduction (P= 0.002) and 63.87% (P= 0.002) TIU-p reduction, respectively. The %ΔTIU-p showed strong (r= 0.602,P= 0.000) and %ΔVshowed moderate (r= 0.416,P= 0.005), while the WHO (r= 0.075,P= 0.627), RECIST (r= 0.270,P= 0.077) and Choi criteria (r= 0.238,P= 0.120) showed no correlation with the Becker score. The differences in PFS time between the responder and non-responder groups were significant according to %ΔTIU-p and Choi criteria (P= 0.001 andP= 0.013, respectively).ConclusionsThe TIU-p can help predict pathological regression in advanced gastric cancer patients after neoadjuvant chemotherapy. In addition, the %ΔTIU-p could be one of the potentially valuable predictive parameters of the PFS time.