Potential of Reduction in Total Tumor Volume Measured with 3D-MRI as a Prognostic Factor for Locally-Advanced Breast Cancer Patients Treated with Primary Chemotherapy
Potential of Reduction in Total Tumor Volume Measured with 3D-MRI as a Prognostic Factor for Locally-Advanced Breast Cancer Patients Treated with Primary Chemotherapy
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DOI：
10.1111/j.1524-4741.2008.00642.x
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发表时间：
2008-11-01
期刊：
影响因子：
2.1
通讯作者：
Noguchi, Shinzaburo
中科院分区：
文献类型：
--
作者：
Akazawa, Kenji;Tamaki, Yasuhiro;Noguchi, Shinzaburo
为了准确评估局部晚期乳腺癌对初次化疗(PCT)的反应，我们使用三维磁共振成像(3D MRI)测量了总肿瘤体积(TTV)的缩小，并研究了这种缩小与患者预后的关系。51例局部晚期乳腺癌患者在手术前接受了四个周期的多西紫杉醇(60 mg/m(2))治疗。化疗前后分别用卡尺、超声(US)和常规二维(2D)MRI测量肿瘤大小。用3DMRI测量TTV。对这些和其他临床病理参数进行统计分析，以确定患者的预后。中位随访时间46个月(1~月)。在51名患者中，有25人发生了远处复发。术后TTV下降75%或以上的患者预后明显好于其他患者，而卡尺、US和2D MRI测量的肿瘤大小与患者的预后无明显关系。在临床病理参数中，只有TTV降低和组织学分级与无复发远期生存率显著相关(p=0.03和0.02，log-ranch检验)，而逐步多因素Cox比例风险分析显示TTV是最强的独立预后因素。3D MRI测量的TTV减少对于接受PCT治疗的局部晚期乳腺癌患者来说是一个有用的预后因素。
For accurate assessment of the response to primary chemotherapy (PCT) for locally advanced breast cancer, we measured reduction in total tumor volume (TTV) by using three-dimensional magnetic resonance imaging (3D MRI), and examined the relationship between this reduction and patient prognosis. Fifty-one patients with locally advanced breast cancer were treated with four cycles of docetaxel (60 mg/m(2)) before surgery. Tumor size was measured with calipers, ultrasonography (US) and conventional two-dimensional (2D) MRI before and after chemotherapy. TTV was measured with 3D MRI. These and other clinicopathological parameters were statistically analyzed to determine the prognosis for the patients. Median follow-up time was 46 months (1-64 months). Of the 51 patients, 25 developed distant recurrences. Patients whose TTV decreased by 75% or more after PCT showed significantly better prognosis than others, while tumor size measured with calipers, US and 2D MRI showed no significant relationship with patient prognosis. Of the clinicopathological parameters, only reduction in TTV and histological grade showed a significant association with distant recurrence-free survival (p = 0.03 and 0.02, log-rank test), while stepwise multivariate Cox's proportional hazards analysis identified TTV as the strongest independent prognostic factor. Reduction in TTV measured with 3D MRI can be a useful prognostic factor for patients with locally advanced breast cancer treated with PCT.