Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
Eur Radiol. 2011 Aug;21(8):1699-708. doi: 10.1007/s00330-011-2102-x. Epub 2011 Mar 12.
To evaluate whether a pharmacokinetic analysis is useful for both predicting and monitoring the response to chemoradiotherapy (CRT) in oral cancer.
Patients with oral squamous cell carcinoma treated with preoperative CRT and surgery were enrolled. They underwent dynamic contrast-enhanced MRI before (n = 23), and after CRT (n = 20). We estimated four parameters: arrival time of contrast medium (TA), exchange rate constant from the extracellular extravascular space (EES) to plasma (k(ep)), elimination of contrast medium from the central compartment (k(el)) and an amplitude scaling constant (AH) using the Brix model. The histological evaluation of the effects of CRT was performed according to Ohboshi and Shimosato's classification. We analysed the correlation between the parameters and the histological evaluation.
The pre-CRT AH between the responders and non-responders was significantly different (P = 0.046), however, the three parameters (TA, K(ep), K(el)) were not significantly different among the groups (P = 0.76, P = 0.60, P = 0.09). As AH decreased, the tumour response improved. The change in the AH between the pre- and post-CRT of responders was significantly higher than that of non-responders (P = 0.043).
The AH, which is affected by the ratio of the EES, was an important parameter for predicting and monitoring the tumour response to CRT.
评估药代动力学分析是否有助于预测和监测口腔癌放化疗（CRT）的反应。
纳入接受术前 CRT 和手术治疗的口腔鳞状细胞癌患者。他们在 CRT 前（n=23）和 CRT 后（n=20）进行了动态对比增强 MRI。我们使用 Brix 模型估计了四个参数：对比剂到达时间（TA）、从细胞外细胞外空间（EES）到血浆的交换率常数（k（ep））、中央隔室对比剂的消除（k（el））和幅度缩放常数（AH）。根据 Ohboshi 和 Shimosato 的分类对 CRT 的组织学效应进行评估。我们分析了参数与组织学评估之间的相关性。
应答者和无应答者之间的 CRT 前 AH 差异具有统计学意义（P=0.046），而三组间的 TA、K（ep）和 K（el）参数均无统计学差异（P=0.76、P=0.60、P=0.09）。随着 AH 的降低，肿瘤的反应性提高。应答者 CRT 前后 AH 的变化明显高于无应答者（P=0.043）。
AH 受 EES 比例的影响，是预测和监测 CRT 肿瘤反应的重要参数。
