Comparison of EORTC Criteria and PERCIST for PET/CT Response Evaluation of Patients with Metastatic Colorectal Cancer Treated with Irinotecan and Cetuximab
Comparison of EORTC Criteria and PERCIST for PET/CT Response Evaluation of Patients with Metastatic Colorectal Cancer Treated with Irinotecan and Cetuximab
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DOI：
10.2967/jnumed.112.111757
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发表时间：
2013-07-01
影响因子：
9.3
通讯作者：
Hendel, Helle Westergren
中科院分区：
文献类型：
--
作者：
Skougaard, Kristin;Nielsen, Dorte;Hendel, Helle Westergren
本研究旨在比较欧洲癌症研究和治疗组织（EORTC）标准与实体瘤PET缓解标准（PERCIST），以评价接受化疗药物伊立替康和单克隆抗体西妥昔单抗联合治疗的转移性结直肠癌患者的缓解。研究方法：从2006年到2009年，转移性结直肠癌患者被前瞻性纳入一项II期试验，评估伊立替康和西妥昔单抗每两周联合治疗作为三线治疗。在首次治疗前1 - 14天和每4个治疗周期后进行F-18-FDG PET/CT检查，直至根据实体瘤疗效评价标准（RECIST）通过CT确定进展。根据EORTC标准和PERCIST回顾性进行F-18-FDG PET/CT缓解评价，将患者分为4个缓解类别：完全代谢缓解（CMR）、部分代谢缓解（PMR）、稳定代谢疾病（SMD）和进行性代谢疾病（PMD）。个体最佳总体代谢应答（BOmR）采用两组标准登记，以及应答类别内的生存期，并进行比较。结果：共有61例患者和203例PET/CT扫描符合缓解评价条件。根据EORTC标准，38例PMR，16例SMD，7例PMD作为其BOmR。对于PERCIST，34例患者的BOmR为PMR，20例患者的BOmR为SMD，7例患者的BOmR为PMD。所有患者均未发生CMR。在87%的患者中，EORTC标准和PERCIST之间存在一致性，相应的kappa系数为0.76。分歧仅限于PMR和SMD。根据EORTC标准，PMR组的中位总生存期（OS）为14.2个月，SMD + PMD联合组为7.2个月。使用PERCIST时，PMR组为14.5，SMD 1 PMD组为7.9。结论：采用EORTC标准和PERCIST进行的缓解评价显示，缓解和OS结局相似，BOmR（κ系数，0.76）一致性良好，缓解组之间的中位OS存在相似的显著差异。与EORTC标准相比，我们发现PERCIST明确，因为定义明确，因此使用更简单。
The study aim was to compare European Organization for Research and Treatment of Cancer (EORTC) criteria with PET Response Criteria in Solid Tumors (PERCIST) for response evaluation of patients with metastatic colorectal cancer treated with a combination of the chemotherapeutic drug irinotecan and the monoclonal antibody cetuximab. Methods: From 2006 to 2009, patients with metastatic colorectal cancer were prospectively included in a phase II trial evaluating the combination of irinotecan and cetuximab every second week, as third-line treatment. F-18-FDG PET/CT was performed between 1 and 14 d before the first treatment and after every fourth treatment cycle until progression was identified by CT with Response Evaluation Criteria in Solid Tumors (RECIST). Response evaluation with F-18-FDG PET/CT was retrospectively performed according to both EORTC criteria and PERCIST, classifying the patients into 4 response categories: complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD). Individual best overall metabolic response (BOmR) was registered with both sets of criteria, as well as survival within response categories, and compared. Results: A total of 61 patients and 203 PET/CT scans were eligible for response evaluation. With EORTC criteria, 38 had PMR, 16 had SMD, and 7 had PMD as their BOmR. With PERCIST, 34 had PMR, 20 had SMD, and 7 had PMD as their BOmR. None of the patients had CMR. There was agreement between EORTC criteria and PERCIST in 87% of the patients, and the corresponding kappa-coefficient was 0.76. Disagreements were confined to PMR and SMD. Median overall survival (OS) in months with EORTC criteria was 14.2 in the PMR group and 7.2 in the combined SMD + PMD group. With PERCIST, it was 14.5 in the PMR group and 7.9 in the SMD 1 PMD group. Conclusion: Response evaluation with EORTC criteria and PERCIST gave similar responses and OS outcomes with good agreement on BOmR (kappa-coefficient, 0.76) and similar significant differences in median OS between response groups. Compared with EORTC criteria, we find PERCIST unambiguous because of clear definitions and therefore more straightforward to use.