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首页> 外文期刊>European urology >Comparison of four early posttherapy imaging changes (EPTIC; RECIST 1.0, tumor shrinkage, computed tomography tumor density, Choi criteria) in assessing outcome to vascular endothelial growth factor-targeted therapy in patients with advanced renal cell carcinoma.
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Comparison of four early posttherapy imaging changes (EPTIC; RECIST 1.0, tumor shrinkage, computed tomography tumor density, Choi criteria) in assessing outcome to vascular endothelial growth factor-targeted therapy in patients with advanced renal cell carcinoma.

机译：在评估晚期肾细胞癌患者以血管内皮生长因子为靶点的治疗结果方面，比较四种早期治疗后影像学改变（EPTIC; RECIST 1.0，肿瘤缩小，计算机断层扫描肿瘤密度，Choi标准）。

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BACKGROUND: Vascular endothelial growth factor (VEGF)-targeted therapy has become standard treatment for patients with metastatic renal cell cancer (mRCC). Since these therapies can induce tumor necrosis and minimal tumor shrinkage, Response Evaluation Criteria in Solid Tumors (RECIST) may not be optimal for predicting clinical outcome. OBJECTIVE: To systematically determine the optimal early posttherapy imaging changes (EPTIC) to separate responders and nonresponders at the first posttreatment follow-up computed tomography (CT). DESIGN, SETTING, AND PARTICIPANTS: Seventy mRCC patients with 155 target lesions treated with first-line sunitinib, sorafenib, or bevacizumab at academic medical centers underwent contrast-enhanced thoracic and abdominal CT at baseline and first follow-up after therapy initiation (median: 78 d after therapy initiation; range: 31-223 d). MEASUREMENTS: Evaluations were performed according to (1) RECIST 1.0; (2) Choi criteria; (3) tumor shrinkage (TS) of >/=10% decrease in sum of the longest unidimensional diameter (SLD); and (4) 15% or 20% decrease in mean CT tumor density. Correlation with time to treatment failure (TTF) and overall survival (OS) were compared and stratified by response to each of the radiologic criteria. RESULTS AND LIMITATIONS: Eleven patients were considered responders by RECIST 1.0; 49 based on Choi criteria; 31 patients had >/=10% decrease in the SLD; and 36 and 32 patients had >/=15% and >/=20% decrease, respectively, in mean tumor density on CT. Only the threshold of 10% decrease in the SLD was statistically significant in predicting TTF (10.4 vs 5.1 mo; p=0.02) and OS (32.5 vs 15.8 mo; p=0.002). Receiver operating characteristic analysis yielded a 10% decrease in SLD as the optimal size change threshold for responders. The retrospective nature of the study and measurements by a single oncoradiologist are inherent limitations. CONCLUSIONS: In the retrospectively analyzed study population of mRCC patients receiving VEGF-targeted agents, a 10% reduction in the SLD on the first follow-up CT was an optimal early predictor of outcome.
机译：背景：靶向血管内皮生长因子（VEGF）的治疗已成为转移性肾细胞癌（mRCC）患者的标准治疗方法。由于这些疗法可诱导肿瘤坏死和最小程度的肿瘤缩小，因此实体瘤反应评估标准（RECIST）可能不是预测临床结果的最佳方法。目的：为了系统地确定最佳的早期治疗后影像学改变（EPTIC），以在首次治疗后随访的计算机体层摄影术（CT）中区分反应者和非反应者。设计，地点和参与者：在学术医学中心用舒尼替尼，索拉非尼或贝伐单抗一线治疗的70例155个目标病灶的mRCC患者在基线和治疗开始后的首次随访中接受了对比增强的胸部和腹部CT检查（中位数：治疗开始后78 d;范围：31-223 d）。测量：根据（1）RECIST 1.0进行评估; （2）彩评标准; （3）最长一维直径（SLD）之和减少> / = 10％的肿瘤缩小率（TS）; （4）平均CT肿瘤密度降低15％或20％。比较了与治疗失败时间（TTF）和总生存期（OS）的相关性，并通过对每个放射学标准的反应进行分层。结果与限制：RECIST 1.0认为有11例患者有反应;根据崔标准49 31名患者的SLD降低> / = 10％; 36例和32例患者的CT平均肿瘤密度分别降低了> / = 15％和> / = 20％。在预测TTF（10.4 vs 5.1 mo; p = 0.02）和OS（32.5 vs 15.8 mo; p = 0.002）方面，只有SLD降低10％的阈值才具有统计学意义。接收器工作特性分析使SLD降低了10％，这是响应者的最佳尺​​寸变化阈值。由一位放射线医师进行的研究和测量的回顾性性质是固有的局限性。结论：在回顾性研究的接受VEGF靶向药物治疗的mRCC患者中，首次随访CT的SLD降低10％是预后的最佳预测指标。

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