Department of Diagnostic Radiology, Institution for Molecular Medicine and Surgery, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden.
Ann Oncol. 2012 Apr;23(4):948-54. doi: 10.1093/annonc/mdr350. Epub 2011 Aug 10.
To determine whether the change in tumor diameters at the first follow-up computed tomography (CT) examination after baseline examination (first change) correlates with outcome in patients with metastatic colorectal cancer (mCRC) treated with combination chemotherapy.
The first change was analyzed in a multicenter randomized phase III trial (Nordic VI, N = 567) comparing first-line irinotecan with either bolus or infused 5-fluorouracil. Cox proportional hazards multiple regression model and Kaplan-Meier survival analyses after correction for guarantee-time bias were carried out to evaluate correlations between first change, objective response according to RECIST 1.0, progression-free survival (PFS), and overall survival (OS).
The hazard ratios for PFS and OS decreased along with first change. A decrease between 10% and <30%, albeit RECIST does not regard this as a partial response, was a positive prognostic factor for PFS and OS. Patients who had new lesions or unequivocal progression of nonmeasurable lesions had a worse prognosis than those with only an increase in size of >20%.
The change in tumor size at the first follow-up CT is strongly prognostic for PFS and OS in mCRC.
为了确定基线检查后第一次随访计算机断层扫描（CT）检查时肿瘤直径的变化是否与接受联合化疗的转移性结直肠癌（mCRC）患者的结局相关。
在一项多中心随机 III 期试验（北欧 VI 期，N=567）中分析了第一次变化，该试验比较了一线伊立替康与推注或输注氟尿嘧啶。进行 Cox 比例风险多因素回归模型和 Kaplan-Meier 生存分析，以校正保证时间偏倚，评估第一次变化、根据 RECIST 1.0 评估的客观缓解、无进展生存期（PFS）和总生存期（OS）之间的相关性。
PFS 和 OS 的风险比随第一次变化而降低。虽然 RECIST 不将 10%至<30%的减少视为部分缓解，但这是 PFS 和 OS 的一个阳性预后因素。有新病变或不可明确的非可测量病变进展的患者比只有>20%的肿瘤大小增加的患者预后更差。
mCRC 患者在第一次随访 CT 时肿瘤大小的变化与 PFS 和 OS 具有很强的预后相关性。
