高级检索

三维放射学对化疗后儿童横纹肌肉瘤患者生存预测研究

Prediction of survival in children with rhabdomyosarcoma after chemotherapy by three-dimensional radiology

    摘要
  • 摘要:
      目的  评估三维放射学预测化疗后儿童横纹肌肉瘤（RMS）患者的生存状况。
      方法  回顾性分析66例接受化疗的RMS患者，采用4种方法测量化疗前后磁共振成像或计算机断层扫描图像上的肿瘤大小，采用1D-实体肿瘤反应评价标准（1D-RECIST）测量肿瘤最大直径；2D-世界卫生组织（2D-WHO）计算2个最大直径的乘积；3D-欧洲儿童软组织肉瘤研究组（3D-EpSSG）计算3个最大直径的乘积；3D-Osirix计算软件辅助下的肿瘤体积。根据每种方法建议的阈值，将患者分为有反应者或无反应者。采用Kaplan-Meier图、log-rank检验和Cox回归分析比较肿瘤反应与生存期。
      结果  Kaplan-Meier结果显示，3种方法有反应者的5年无事件生存期（5y-EFS）长于无反应者，且3D-EpSSG在评估有反应者和无反应者之间的差异方面优于1D-RECIST或2D-WHO评估（P1D-RECIST=0.018，P2D-WHO=0.007，P3D-EpSSG和P3D-Osirix < 0.001）。1D-RECIST的校正5y-EFS的危险比为3.57（P=0.016），2D-WHO的校正危险比为5.05（P=0.004），3D-EpSSG为14.40（P < 0.001），3D-Osirix为11.60（P < 0.001）。
      结论  早期肿瘤的反应是RMS的一个重要预后因素，3D-EpSSG和3D-Osirix方法对RMS化疗后的生存预测优于1D-RECIST和2D-WHO。

     

    Abstract:
      Objective  To evaluate the survival situations of children with rhabdomyosarcoma (RMS) after chemotherapy predicted by three-dimensional radiology.
      Methods  A total of 66 patients with RMS who received chemotherapy were retrospectively analyzed. Four methods were used to measure the tumor size on magnetic resonance or computed tomography images before and after chemotherapy. Maximal diameter was measured with Response Evaluation Criteria in Solid Tumors (1D-RECIST); multiplying the two maximal diameters was calculated with World Health Organization (2D-WHO); multiplying the three maximal diameters was calculated with European pediatric soft tissue sarcoma Study Group (3D-EpSSG); a software-assisted volume assessment was measured with the 3D-Osirix. Patients were classified as responders or non-responders based on the proposed thresholds for each method. Tumor response was compared with survival using Kaplan-Meier plots, the log-rank test, and Cox's regression.
      Results  Kaplan-Meier results showed that among the three methods, 5-year event free survival (5y-EFS) responders were longer than non-responders, and the difference of 3D-EpSSG evaluation between responder and non-responder was better than 1D-RECIST or 2D-WHO (P1D-RECIST=0.018, P2D-WHO=0.007, P3D-EpSSG and P3D-OsiriX < 0.001). In terms of 5y-EFS between the two groups, the adjusted hazard ratio of 1D-RECIST was 3.57 (P=0.016), 5.05 for 2D-WHO (P=0.004), 14.40 for 3D-EpSSG (P < 0.001), and 11.60 for 3D-Osirix (P < 0.001).
      Conclusion  Early tumor response is confirmed as a significant prognostic factor in RMS, and 3D-EpSSG and 3D-Osirix methods are superior to 1D-RECIST and 2D-WHO in predicting survival after chemotherapy for RMS.

     

    • HTML全文
    • 参考文献(23)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回