Radiology:灌注CT评价胰腺导管内腺癌新辅助放化疗的效果

2019-10-13 shao sai MedSci原创

背景:CT图像中肿瘤大小尚不足以有效地评价新辅助放化疗(CRT)的治疗效果,且与组织学分级相关性较差。本研究旨在验证利用灌注CT预测胰腺导管内腺癌(PDA)对CRT的治疗反应。

背景:CT图像中肿瘤大小尚不足以有效地评价新辅助放化疗(CRT)的治疗效果,且与组织学分级相关性较差。本研究旨在验证利用灌注CT预测胰腺导管内腺癌(PDA)对CRT的治疗反应。

本研究共纳入了经病理证实的PDA患者,在CRT前后进行灌注CT检查。在CT图像中测量血流(BF)、血容量(BV)和渗透-表面积乘积(PSP)。根据治疗反应将患者分为治疗反应者与治疗无反应者。利用Mann-Whitney检验比较两组基线灌注指标,利用Wilcoxon配对符号等级检验比较CRT前后灌注指标。

结果为,本研究共纳入了21例CRT术前行动态灌注CT的患者。所有受试者均行胰腺切除手术。18例患者行CRT术后灌注CT。CRT治疗有反应患者基线BF要高于无无反应者(中位数44 [IQR, 39-56] vs 28 [IQR, 16-52] mL/100 g/min; P = .04),两组BV和PSP无明显差异(中位数BV, 4.3 [IQR, 3.5-6.9] vs 2.0 [IQR, 1.6-6.5] mL/100 g, P = .15; 中位数PSP, 25 [IQR, 21-30] vs 20 [IQR, 10-34] mL/100 g/min, P = .31)。RECIST和CA199与灌注参数(RECIST 、 BF: r = 0.05, P = .84, 95%CI: -0.40, 0.48; CA 19-9 、 BF: r = 0.06, P = .78, 95% CI: -0.39, 0.49)和组织病理学反应(r = 0.16, P = .47, 95% CI: -0.3, 0.57 、 r = 0.09, P = .71, 95% CI: -0.37, 0.51)并无显着相关性。对于治疗有反应患者,经CRT后灌注参数增高(中位数BF, 54 [IQR, 42-73] vs 43 [IQR, 28-53] mL/100 g/min; P = .04)。对于治疗无反应者,灌注参数并无显着性变化(中位数BF, 43 [IQR, 28-53] vs 33 [IQR, 16-52] mL/100 g/min; P = .06)。

本研究表明,灌注CT检查可能有助于预测胰腺导管内腺癌治疗的组织病理学反应。

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    2019-10-15 yzh399
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    2019-10-15 huagfeg
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    2019-10-13 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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