Department of Radiology, Dana-Farber Cancer Institute and Brigham and Womens Hospital, Boston, MA 02215-5450, USA.
Cancer Imaging. 2012 Jun 29;12(1):225-35. doi: 10.1102/1470-7330.2012.0027.
To investigate the frequency and radiographic patterns of tumoral cavitation in patients with non-small cell lung cancer (NSCLC) treated with bevacizumab, and correlate the imaging findings with the pathology, clinical characteristics and outcome.
Seventy-two patients with NSCLC treated with bevacizumab therapy were identified retrospectively. Baseline and follow-up chest computed tomography scan were reviewed to identify tumoral cavitation and subsequent filling in of cavitation. Radiographic cavitation patterns were classified into 3 groups. The clinical and outcome data were correlated with cavity formation and patterns.
Out of 72 patients, 14 patients developed cavitation after the initiation of bevacizumab therapy (19%; median time to event, 1.5 months; range 1.0-24.8 months). Three radiographic patterns of tumoral cavitation were noted: (1) development of cavity within the dominant lung tumor (n = 8); (2) development of non-dominant cavitary nodules (n = 3); and (3) development of non-dominant cavitary nodules with adjacent interstitial abnormalities (n = 3). Eleven patients (79%) demonstrated subsequent filling in of cavitation (the time from the cavity formation to filling in; median 3.7 months; range 1.9-22.7 months). No significant difference was observed in the clinical characteristics, including smoking history, or in the survival between patients who developed cavitation and those who did not. Smoking history demonstrated a significant difference across 3 radiographic cavitation patterns (P = 0.006). Hemoptysis was noted in 1 patient with cavity formation and 4 patients without, with no significant difference between the 2 groups.
Tumoral cavitation occurred in 19% in patients with NSCLC treated with bevacizumab and demonstrated 3 radiographic patterns. Subsequent filling in of cavitation was noted in the majority of cases.
研究贝伐珠单抗治疗非小细胞肺癌（NSCLC）患者肿瘤空洞的发生率和影像学表现，并将影像学结果与病理、临床特征和预后相关联。
回顾性分析了 72 例接受贝伐珠单抗治疗的 NSCLC 患者。对患者的基线和随访胸部 CT 扫描进行了评估，以识别肿瘤空洞和随后的空洞填充。将影像学空洞模式分为 3 组。将临床和预后数据与空洞形成和模式进行了相关性分析。
72 例患者中有 14 例在开始贝伐珠单抗治疗后出现空洞（19%；中位时间为 1.5 个月；范围 1.0-24.8 个月）。观察到 3 种肿瘤空洞的影像学模式：（1）在主要肺部肿瘤内出现空洞（8 例）；（2）出现非优势性空洞性结节（3 例）；（3）出现非优势性空洞性结节并伴有相邻间质异常（3 例）。11 例（79%）患者的空洞随后出现了填充（从空洞形成到填充的时间；中位数为 3.7 个月；范围 1.9-22.7 个月）。在临床特征方面，包括吸烟史或生存方面，在发生空洞和未发生空洞的患者之间没有观察到显著差异。吸烟史在 3 种影像学空洞模式之间存在显著差异（P = 0.006）。有 1 例出现空洞形成的患者出现咯血，而 4 例无空洞形成的患者也出现咯血，两组之间无显著差异。
在接受贝伐珠单抗治疗的 NSCLC 患者中，肿瘤空洞的发生率为 19%，并表现出 3 种影像学模式。大多数患者出现了空洞的随后填充。
