We should desist using RECIST, at least in GIST
We should desist using RECIST, at least in GIST
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DOI：
10.1200/jco.2006.07.3411
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发表时间：
2007-05-01
影响因子：
45.3
通讯作者：
Charnsangavej, Chuslip
中科院分区：
文献类型：
--
作者：
Benjamin, Robert S.;Choi, Haesun;Charnsangavej, Chuslip
目的实体瘤疗效评价标准（RECIST）在评价伊马替尼治疗的胃肠道间质瘤（GIST）时不敏感。根据Choi标准的缓解，即对比增强CT上大小减小10%或密度减小15%，在一小部分通过正电子发射断层扫描测量显示缓解的患者训练集中相关性良好，并且比RECIST缓解更能预测肿瘤进展时间（TTP）。本研究的目的是验证这些观察结果在一个独立的dataset.Patients和MethodsFifty-eight伊马替尼治疗的GIST患者进行了评价，RECIST和崔标准。将TTP与训练集中的TTP进行比较。患者进行了初步分析，随访至28个月，延长至60个月的生存analysis.ResultsPatients谁满足Choi响应标准的CT在2个月有显着更好的TTP比那些没有（P =.0002），而响应组的RECIST与TTP没有显着相关性。即使将两组的98例患者一起分析，RECIST标准的反应组与TTP无显著相关性，而Choi标准的反应组与TTP显著相关。疾病特异性生存期（DSS）也显着相关性与响应组的Choi标准（P =.04），但不与响应组的RECIST.ConclusionChoi响应标准是可重复的，更敏感，更精确的比RECIST在评估GIST对甲磺酸伊马替尼的反应。与RECIST缓解不同，Choi标准缓解与TTP和DSS显著相关。Choi标准的反应应常规纳入未来的GIST治疗研究。我们应该停止使用RECIST，至少在GIST中。
PurposeResponse Evaluation Criteria in Solid Tumors (RECIST) are insensitive in evaluating imatinib-treated gastrointestinal stromal tumors (GISTs). Response by Choi criteria, a 10% decrease in size or a 15% decrease in density on contrast-enhanced CT, correlated well in a small training set of patients who showed response as measured by positron emission tomography, and was more predictive of time to tumor progression (TTP) than response by RECIST. This study was designed to validate these observations in an independent data set.Patients and MethodsFifty-eight patients with imatinib-treated GISTs were evaluated by RECIST and Choi criteria. TTP was compared with TTP in the training set. Patients were analyzed initially with follow-up to 28 months, extended to 60 months for survival analysis.ResultsPatients who met Choi response criteria on CT at 2 months had significantly better TTP than those who did not ( P =.0002), whereas response group by RECIST was not significantly correlated with TTP. Even when the 98 patients from both sets were analyzed together, the response group by RECIST did not correlate significantly with TTP, whereas response group by Choi criteria did correlate significantly with TTP. Disease-specific survival (DSS) was also significantly correlated with response group by Choi criteria ( P =.04), but not with response group by RECIST.ConclusionChoi response criteria are reproducible, more sensitive, and more precise than RECIST in assessing the response of GISTs to imatinib mesylate. Response by Choi criteria, unlike response by RECIST, correlates significantly with TTP and DSS. Response by Choi criteria should be incorporated routinely into future studies of GIST therapy. We should desist using RECIST, at least in GIST.