Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
J Magn Reson Imaging. 2012 Sep;36(3):589-97. doi: 10.1002/jmri.23704. Epub 2012 May 30.
To evaluate whether a pharmacokinetic analysis is useful for monitoring the response of oral cancer to chemoradiotherapy (CRT).
Twenty-nine patients were included. They underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before and after CRT. The DCE-MRI data were analyzed using a Tofts and Kermode (TK) model. The histological evaluation of the effects of CRT was performed according to Ohboshi and Shimosato's classification.
None of the pre-CRT parameters were significantly different between the responders and nonresponders. The post-CRT volume of the extravascular extracellular space (EES) per unit volume of tissue (v(e) ) of responders (0.397 ± 0.080) was higher than that of nonresponders (0.281 ± 0.076) (P = 0.01). The change of the v(e) between the pre- and post-CRT of the responders (0.154 ± 0.093) was larger than that of the nonresponders (0.033 ± 0.073) (P = 0.001). Therefore, the increase in the v(e) strongly suggested a good tumor response to CRT, which reflected an increase of the EES secondary to the destruction of the cancer nest. The changes in the volume transfer constant (K(trans) ) were significantly different between the responders and nonresponders (P = 0.018).
Both the increase of the v(e) and the elevation of permeability (K(trans) ) were indicative of a good tumor response to CRT. The pharmacokinetic analysis had potential for monitoring the histopathological response to CRT.
评估药代动力学分析是否有助于监测口腔癌接受放化疗（CRT）的反应。
共纳入 29 例患者。他们在 CRT 前后均接受了动态对比增强磁共振成像（DCE-MRI）检查。使用 Tofts 和 Kermode（TK）模型对 DCE-MRI 数据进行分析。根据 Ohboshi 和 Shimosato 的分类对 CRT 效果的组织学评估进行。
在反应者和无反应者之间，没有任何预处理参数存在显著差异。反应者 CRT 后单位组织血管外细胞外空间（EES）体积（v(e)）（0.397±0.080）高于无反应者（0.281±0.076）（P=0.01）。反应者的 v(e)在预处理和 CRT 后的变化（0.154±0.093）大于无反应者（0.033±0.073）（P=0.001）。因此，v(e）的增加强烈提示 CRT 对肿瘤反应良好，这反映了由于癌巢破坏导致 EES 增加。反应者和无反应者之间的体积转移常数（K(trans)）变化有显著差异（P=0.018）。
v(e）的增加和通透性（K(trans)）的升高均提示 CRT 对肿瘤反应良好。药代动力学分析可能有助于监测 CRT 的组织病理学反应。
