Prasad Srinivasa R, Jhaveri Kartik S, Saini Sanjay, Hahn Peter F, Halpern Elkan F, Sumner James E
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 32 Fruit St, White 270-E, Boston, MA 02114, USA.
Radiology. 2002 Nov;225(2):416-9. doi: 10.1148/radiol.2252011604.
To compare unidimensional, bidimensional, and volumetric techniques for evaluation of treatment response in patients with liver metastases from breast cancer in a phase III clinical trial.
Helical computed tomographic (CT) studies in 38 patients with liver metastases from breast cancer who were enrolled in a phase III clinical trial were evaluated before treatment and at 6 months after treatment. Two subspecialty radiologists measured all lesions on transverse CT scans with use of electronic calipers according to both unidimensional and bidimensional criteria. Volumetric measurements were made by tracing individual lesions. Measurements of individual lesions were summed to obtain patient response, which was categorized as complete response, disappearance of lesions; partial response, greater than 30% decrease in tumor diameter (unidimensional), greater than 50% reduction in tumor area (bidimensional), or greater than 65% reduction in tumor volume (volumetric); disease progression, greater than 20% increase in tumor diameter, greater than 25% increase in tumor area, or greater than 73% increase in tumor volume: or stable disease (size response other than that of complete response, partial response, or disease progression).
In 37 patients, there was concordant treatment response with use of unidimensional and bidimensional techniques. Volumetric measurement produced results different from those of the unidimensional and bidimensional techniques in 12 and 13 patients, respectively. In six patients with partial response per unidimensional and bidimensional criteria, the response based on the volumetric technique was stable disease. In two patients with stable disease per bidimensional and unidimensional criteria, the response was partial response by volumetric measurement. In four patients with disease progression per bidimensional and unidimensional criteria, the response was stable disease per volumetric criteria.
Volumetric measurement of tumor burden gives different results for treatment response compared with that of the unidimensional or bidimensional technique in a considerable proportion of patients.
在一项III期临床试验中，比较单维度、双维度和容积技术评估乳腺癌肝转移患者治疗反应的情况。
对38例参加III期临床试验的乳腺癌肝转移患者在治疗前和治疗后6个月进行螺旋计算机断层扫描（CT）检查。两名专科放射科医生根据单维度和双维度标准，使用电子卡尺在横断位CT扫描上测量所有病灶。通过描绘各个病灶进行容积测量。将各个病灶的测量值相加得出患者的反应，分为完全缓解（病灶消失）、部分缓解（肿瘤直径单维度测量下降超过30%，肿瘤面积双维度测量缩小超过50%，或肿瘤容积测量缩小超过65%）、疾病进展（肿瘤直径增加超过20%，肿瘤面积增加超过25%，或肿瘤容积增加超过73%）或疾病稳定（除完全缓解、部分缓解或疾病进展之外的大小反应）。
37例患者使用单维度和双维度技术得出的治疗反应一致。容积测量分别在12例和13例患者中得出与单维度和双维度技术不同的结果。在根据单维度和双维度标准判定为部分缓解的6例患者中，基于容积技术的反应为疾病稳定。在根据双维度和单维度标准判定为疾病稳定的2例患者中，容积测量显示为部分缓解。在根据双维度和单维度标准判定为疾病进展的4例患者中，容积标准显示为疾病稳定。
在相当一部分患者中，肿瘤负荷的容积测量得出的治疗反应结果与单维度或双维度技术不同。
