Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Transl Oncol. 2012 Aug;5(4):238-46. doi: 10.1593/tlo.11346. Epub 2012 Aug 1.
The aim of this study was to investigate the potential of diffuse optical spectroscopy for monitoring of patients with locally advanced breast cancer (LABC) undergoing neoadjuvant chemotherapy. Fifteen women receiving treatment for LABC had the affected breast scanned before; 1 week, 4 weeks, and 8 weeks after treatment initiation; and before surgery. Optical properties related to tissue microstructure and biochemical composition were obtained. Clinical and pathologic tumor response was evaluated using whole-mount pathology after mastectomy. Patients who responded to treatment demonstrated an initial increase followed by a drop in optical parameters measured in the whole breast, whereas nonresponding patients demonstrated only a drop in the same parameters 1 week after treatment initiation. Responding patients demonstrated a significant increase of 17% ± 7%, 8% ± 8%, 10% ± 7%, 11% ± 11%, and 16% ± 15% in deoxygenated hemoglobin, oxygenated hemoglobin, total hemoglobin concentrations, water percentage, and tissue optical index, 1 week after treatment initiation, respectively. In contrast, nonresponding patients had a decrease of 14% ± 9%, 18% ± 7%, 17% ± 7%, 29% ± 7%, and 32% ± 9% in their corresponding optical parameters. Deoxygenated hemoglobin concentration (with 100% sensitivity, 83% specificity) and water percentage (with 75% sensitivity, 100% specificity) were found to be the best predictors of treatment response at 1 week after starting treatment. The results of this study suggest that optical parameters can be potentially used to predict and monitor patients' responses to neoadjuvant chemotherapy and can form a basis for the customization of treatments in which inefficacious treatments can be switched to more efficacious therapies.
本研究旨在探讨漫射光学光谱技术在监测接受新辅助化疗的局部晚期乳腺癌（LABC）患者中的应用潜力。15 名接受 LABC 治疗的女性在治疗前、治疗开始后 1 周、4 周和 8 周以及手术前接受了受影响乳房的扫描。获得了与组织微观结构和生化组成相关的光学特性。通过乳房切除术的全层病理学评估临床和病理肿瘤反应。对治疗有反应的患者表现为初始增加，随后在整个乳房测量的光学参数下降，而无反应的患者在治疗开始后 1 周仅表现出相同参数的下降。有反应的患者在治疗开始后 1 周分别显示出 17%±7%、8%±8%、10%±7%、11%±11%和 16%±15%的去氧血红蛋白、氧合血红蛋白、总血红蛋白浓度、水百分比和组织光学指数的显著增加。相比之下，无反应的患者在相应的光学参数中分别减少了 14%±9%、18%±7%、17%±7%、29%±7%和 32%±9%。治疗开始后 1 周时，去氧血红蛋白浓度（灵敏度 100%，特异性 83%）和水百分比（灵敏度 75%，特异性 100%）被发现是预测治疗反应的最佳指标。这项研究的结果表明，光学参数可用于预测和监测患者对新辅助化疗的反应，并为定制治疗提供依据，从而可以将无效的治疗方案转换为更有效的治疗方案。
