预处理肿瘤生长速率对肝细胞癌经动脉化疗栓塞客观反应的影响-ag捕鱼平台

background and aim
the study aims to assess the influence of pretreatment tumor growth rate (tgr) on modified response evaluation criteria in solid tumors (mrecist) objective response (or) after a first session of selective transarterial chemoembolization (tace) for the treatment of hepatocellular carcinoma (hcc).

背景和目的

本研究旨在评估预处理肿瘤生长速率(tgr)对肝细胞癌(hcc)选择性经动脉化疗栓塞(tace)治疗第一阶段后改良的实体瘤反应评估标准(mrecist)客观反应(or)的影响。

methods
one hundred fifteen patients (101 men [88%], mean 65.1±10.5 years [range 26-87]) with 169 tumors (mean 34.2±29.3 mm [10-160]), undergoing a first session of selective tace for the treatment of hcc between 2011 and 2016, were included. tgr was calculated as the percentage change in tumor volume per month (%/month) on imaging before treatment. tgr cut-off for prediction of or was identified by receiver operating characteristic curve analysis. 

方法

共纳入2011年至2016年间进行第一阶段选择性tace治疗的hcc患者115例，其中101例(88%)为男性，平均年龄65.1±10.5岁(范围：26-87岁)，肿瘤数目169个(平均大小34.2±29.3 mm [10-160])。tgr的计算方法为治疗前影像学检查中肿瘤体积每月变化百分比(%/月)。采用roc曲线分析确定预测or的tgr截断值。

results
overall 88/189 (52%) and 46/189 (27%) tumors showed complete response (cr) and partial response (pr) (or rate 79%), while 32/189 (19%) showed stable disease (sd), and 3/189 (2%) were progressive disease (pd) on computed tomography at 1-month post-tace. the mean pretreatment tgr was 12.0±15.4 (-3.2-90.4) %/month. tgr of tumors showing cr, pr, sd, and pd was a mean 13.2±16.4%, 12.1±15.1%, 5.3±4.5%, and 44.8±20.4%, respectively (p < 0.001). the three tumors showing pd had tgr values > 20%/month. tgr was significantly higher in tumors with or (12.8±15.9% vs 5.3±4.5% in sd, p = 0.009). a cut-off value of 6.5%/month had the highest predictive value of or (auroc 0.65±0.05, p = 0.009). 

结果

总体来看，88/189(52%)和46/189(27%)的肿瘤在tace术后1个月的ct扫描中显示出完全缓解(cr)和部分缓解(pr)(客观缓解率79%)，32/189(19%)显示为疾病稳定(sd)，3/189(2%)为疾病进展(pd)。平均预处理tgr为12.0±15.4 (-3.2-90.4) %/月。肿瘤tgr显示cr、pr、sd、pd值分别为13.2±16.4%、12.1±15.1%、5.3±4.5%、44.8±20.4%，(p < 0.001)。3个肿瘤显示为pd，tgr值> 20%/月。与sd相比，tgr值在取得or的肿瘤中显著增加(12.8±15.9% vs. 5.3±4.5%, p = 0.009)。tgr截断值为6.5%/月时，or的预测值最高(roc曲线下面积0.65±0.05, p = 0.009)。

conclusion
pretreatment tgr is highly variable in hcc before tace with a u-shaped distribution for the prediction of tumor response. it provides insight into tumor biology that may be used during pretreatment workup to help stratify patients.

结论丨

hcc患者进行tace前的预处理tgr变化较大，在预测肿瘤反应方面呈u型分布。这为深入了解肿瘤生物学提供了依据，可应用于肿瘤预处理中，以帮助对患者进行分层。