Inadequacy of the RECIST criteria for response evaluation in patients with malignant pleural mesothelioma
Inadequacy of the RECIST criteria for response evaluation in patients with malignant pleural mesothelioma
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DOI：
10.1016/s0169-5002(03)00292-7
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发表时间：
2004-01-01
期刊：
影响因子：
5.3
通讯作者：
van Meerbeeck, JP
中科院分区：
文献类型：
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作者：
van Klaveren, RJ;Aerts, JGJV;van Meerbeeck, JP
新引入的实体瘤疗效评价标准（RECIST）依赖于肿瘤的单一最大尺寸，而不是世界卫生组织（WHO）的垂直直径乘积，旨在简化肿瘤疗效的评估。目的：与WHO标准相比，评价RECIST的性能和有效性。设计：前瞻性评价了34例连续的二维可测量恶性胸膜间皮瘤（MPM）患者。结果如下：27%（9/34）患者的WHO和RECIST缓解评价存在差异，9%（3/34）涉及最佳缓解，18%（6/34）涉及客观确认缓解。24%（8/34）的疾病进展被RECIST遗漏。由于RECIST的强调，检测到WHO和RECIST之间存在一个或多个不一致的患者百分比为47.88%。在一个由24名仅具有二维可测量胸膜病变的MPM患者组成的亚组中，差异率为29%，这始终是由于RECIST的强调。然而，当在同一亚组中使用改良的RECIST缓解评价时，差异率为21%，并且在所有情况下都是由于WHO的强调。结论：对于MPM，二维WHO反应评估不能自动被RECIST取代，因为MPM具有非球形生长模式。我们的建议是，根据最近完成的培美曲塞（Alimta（R））治疗MPM试验中使用的方法，使用WHO标准（二维可测量病变）、RECIST标准（一维可测量病变）和改良的RECIST缓解评价（其中使用垂直于胸壁的短轴）来评估胸膜增厚疾病。(C)2003爱思唯尔爱尔兰有限公司保留所有权利。
The newly introduced Response Evaluation Criteria in Solid Tumors (RECIST), which relies on a single largest dimension of tumor rather than on the product of perpendicular diameters World Health Organisation (WHO) is intended to simplify the assessment of tumor response. Purpose: Is to evaluate the performance and validity of the RECIST compared to the WHO criteria. Design: Thirty-four consecutive patients with bidimensionally measurable malignant pleural mesothelioma (MPM) were evaluated prospectively. Results: In 27% (9/34) a discrepancy was found between the WHO and RECIST response evaluation 9% (3/34) concerned best responses and 18% (6/34) objective confirmed responses. In 24% (8/34) disease progression was missed by RECIST. The percentage of patients in whom one or more discordance's between WHO and RECIST were detected was 47, 88% due to underscoring by RECIST. In a subgroup of 24 MPM patients with bidimensionally measurable pleural lesions only, the discrepancy rate was 29%, always due to underscoring by RECIST. However, when in the same subgroup the modified RECIST response evaluation was used the discrepancy rate was 21% and in all cases due to underscoring by WHO. Conclusion: For MPM bidimensional WHO response evaluation cannot automatically be replaced by RECIST because MPM has a non-spherical growth pattern. Our recommendation is to use the WHO criteria for bidimensional measurable lesions, RECIST for unidimensional measurable lesions and a modified RECIST response evaluation, in which the short axis perpendicular to the chest wall is used, for thickened pleural rind disease, according to the method used in the recently completed pemetrexed (Alimta(R)) trial for MPM. (C) 2003 Elsevier Ireland Ltd. All rights reserved.