1. Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
J Cancer. 2010 Jun 28;1:80-92. doi: 10.7150/jca.1.80.
Response criteria represent the standard by which the efficacy of therapeutic agents is determined in cancer trials. The most widely used criteria are based on the anatomic measurement of solid tumors. Because bone metastases are typically located in irregularly shaped bones and are difficult to measure with rulers, they have been previously considered unmeasurable disease. New developments in cancer response criteria have increased awareness of the importance of the response of bone metastases to therapy. The recently updated Response Evaluation Criteria in Solid Tumors (RECIST 1.1) now consider bone metastases with soft tissue masses > 10 mm to be measurable disease. Response criteria specific to bone metastases have been developed at The University of Texas MD Anderson Cancer Center (MDA criteria) and can be used to assess therapeutic response in numerous types of bone metastases. Functional imaging criteria, such as the recently developed Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) allow response to be measured in the absence of anatomic change through assessment of metabolic activity. As monitoring tumor response of bone metastases becomes more important in the management of cancer, so does the demand on radiologists and nuclear medicine physicians for accurate interpretation of the behavior of these lesions. This article reviews anatomic, bone, and metabolic response criteria, providing illustrations for the interpretation of therapy-induced change in bone metastases.
响应标准代表了在癌症试验中确定治疗药物疗效的标准。最广泛使用的标准基于实体瘤的解剖测量。由于骨转移通常位于形状不规则的骨骼中，并且难以用尺子测量，因此以前被认为是无法测量的疾病。癌症反应标准的新发展提高了人们对骨转移对治疗反应的重要性的认识。最近更新的实体瘤反应评估标准（RECIST 1.1）现在认为软组织肿块> 10mm 的骨转移是可测量的疾病。德克萨斯大学 MD 安德森癌症中心（MDA 标准）制定了专门针对骨转移的反应标准，可用于评估多种类型的骨转移的治疗反应。功能成像标准，如最近开发的实体瘤正电子发射断层扫描反应标准（PERCIST），允许通过评估代谢活性在没有解剖变化的情况下测量反应。随着监测骨转移肿瘤反应在癌症管理中的重要性不断提高，放射科医生和核医学医师对这些病变行为进行准确解读的需求也在不断增加。本文综述了解剖学、骨骼和代谢反应标准，并提供了骨转移治疗诱导变化的解释示例。
