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首页> 外文期刊>Breast cancer research and treatment. >Monitoring the size and response of locally advanced breast cancers to neoadjuvant chemotherapy (weekly paclitaxel and epirubicin) with serial enhanced MRI.
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Monitoring the size and response of locally advanced breast cancers to neoadjuvant chemotherapy (weekly paclitaxel and epirubicin) with serial enhanced MRI.

机译：通过系列增强MRI监测局部晚期乳腺癌对新辅助化疗（每周紫杉醇和表柔比星）的大小和反应。

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PURPOSE: To determine if early cancer size reduction seen on enhanced magnetic resonance imaging (MRI) can serve as a response predictor and to correlate final tumor sizes on MRI and excised gross tumor size to microscopic findings in patients with locally advanced breast cancers treated with preoperative neoadjuvant chemotherapy. METHODS AND MATERIALS: Thirty-three patients with advanced breast cancer entered this prospective chemotherapeutic study. Serial, dynamic, enhanced MRI was performed before chemotherapy induction, after the first course of chemotherapy and after the third course of chemotherapy prior to surgery. Responses were measured by image subtraction of tumor size on subsequent axial MRIs using the response evaluation criteria in solid tumors (RECIST). Early tumor size reduction, percentage of relative early tumor size reduction and final tumor size response were calculated and analyzed statistically. Sizes of residual tumors measured on MRI and gross tumors in excised breasts were correlated with microscopic findings. RESULTS: Based on tumor sizes measured with enhanced MRI, four complete responders (CR), 19 partial responders (PR) and 10 non-responder were documented. Twelve (52%) of the 23 responders (CR and PR)had reached the criteria for PR (> or = 30% size reduction) after the first course of chemotherapy. All CR had a marked early size reduction (ESR) of more than 45%. Using the receiver operating characteristic (ROC) curve, a good cutoff point for early tumor size reduction was 7.4 cm, with a false positive rate of 0.1 and a false negative rate of 0.13. The percentage of ESR was 8.8%, with a false positive rate of 0.1 and a false negative rate of 0.09. Residual tumor size on MRI correlated well with microscopic findings (r = 0.982, p < 0.001) and gross tumor size in excised breasts correlated moderately with microscopic findings (r = 0.640, p < 0.001). CONCLUSION: Serial, dynamic, enhanced MRI monitoring of chemotherapeutic response in patients with locally advanced breast cancer can be used to assess early response to chemotherapy and post-chemotherapy tumor size change. Although the residual tumor size on MRI correlated well with the microscopic findings, surgical determination of residual cancer load is still recommended to avoid underestimation.
机译：目的：确定增强磁共振成像（MRI）上发现的早期癌变是否可以作为反应的预测指标，并将MRI上的最终肿瘤大小和切除的总肿瘤大小与术前治疗的局部晚期乳腺癌患者的镜下发现相关联新辅助化疗。方法和材料：33例晚期乳腺癌患者参加了这项前瞻性化学治疗研究。在手术诱导之前，化疗的第一疗程之后和化疗的第三疗程之后，进行了一系列动态，增强的MRI。使用实体瘤中的反应评估标准（RECIST），在随后的轴向MRI上通过对肿瘤大小进行图像减影来测量反应。计算早期肿瘤尺寸减小，相对早期肿瘤尺寸减小的百分比和最终肿瘤尺寸响应，并进行统计学分析。 MRI测量的残留肿瘤大小和切除的乳房中的肉眼肿瘤与显微镜下发现相关。结果：基于增强MRI测量的肿瘤大小，记录了四个完全缓解者（CR），19个部分缓解者（PR）和10个非缓解者。在第一个化学疗法疗程后，在23位反应者（CR和PR）中，有十二位（52％）达到了PR（≥或=缩小30％）标准。所有CR的早期尺寸缩小（ESR）均超过45％。使用接收器工作特性（ROC）曲线，早期肿瘤缩小的好分界点为7.4 cm，假阳性率为0.1，假阴性率为0.13。 ESR的百分比为8.8％，假阳性率为0.1，假阴性率为0.09。 MRI上的残留肿瘤大小与显微镜下的发现有很好的相关性（r = 0.982，p <0.001），而切除乳房的总肿瘤大小与显微镜下的发现有中等的相关性（r = 0.640，p <0.001）。结论：对局部晚期乳腺癌患者的化疗反应进行连续，动态，增强的MRI监测可用于评估对化疗和化疗后肿瘤大小变化的早期反应。尽管MRI上的残留肿瘤大小与显微镜下的发现有很好的相关性，但仍建议通过手术确定残留的癌症负荷，以免低估。

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