Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seodaemun-ku, Shinchon-dong 134, Seoul 120-752, Republic of Korea.
AJR Am J Roentgenol. 2012 Oct;199(4):809-15. doi: 10.2214/AJR.11.7910.
Our retrospective study compared Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 with modified CT criteria to determine their respective utilities as a prognostic indicator. Using both sets of criteria, we compared treatment responses of patients with colorectal liver metastases treated with bevacizumab-containing chemotherapy with those of patients treated with chemotherapy alone.
Fifty-nine patients who received bevacizumab-containing chemotherapy (n=30, group 1) or chemotherapy alone (n=29, group 2) for the treatment of colorectal carcinoma underwent contrast-enhanced CT before treatment and 2 months after treatment. Two radiologists determined changes in tumor size and density between the pretreatment and 2-month follow-up CT images. RECIST 1.1 assesses responses on the basis of changes in tumor size, and the modified CT criteria assesses responses on the basis of changes in tumor density and size. Responses were correlated with time to tumor progression by log rank test.
According to RECIST 1.1, nine of 30 patients (30%) in group 1 and 12 of 29 patients (41%) in group 2 were good responders. According to the modified CT criteria, 23 of 30 patients in group 1 (77%) and 23 of 29 patients in group 2 (79%) were good responders. As assessed by the modified CT criteria, good responders in both groups had significantly longer time to tumor progression than poor responders (p<0.05). As assessed by RECIST 1.1, good responders in group 1 had significantly longer time to tumor progression than poor responders (p=0.0154), but there was no difference in group 2.
Evaluating treatment response with tumor size and density changes on CT was a better predictor of time to tumor progression than changes in tumor size alone in both groups.
本回顾性研究比较了实体瘤反应评估标准 1.1 版（RECIST 1.1）与改良 CT 标准，以确定它们作为预后指标的各自效用。使用这两套标准，我们比较了接受贝伐珠单抗联合化疗治疗的结直肠癌肝转移患者与仅接受化疗治疗的患者的治疗反应。
59 例接受贝伐珠单抗联合化疗（n=30，组 1）或单纯化疗（n=29，组 2）治疗结直肠癌的患者在治疗前和治疗后 2 个月行增强 CT 检查。两名放射科医生根据治疗前和 2 个月随访 CT 图像确定肿瘤大小和密度的变化。RECIST 1.1 基于肿瘤大小的变化评估反应，改良 CT 标准基于肿瘤密度和大小的变化评估反应。通过对数秩检验将反应与肿瘤进展时间相关联。
根据 RECIST 1.1，组 1 的 30 例患者中 9 例（30%）和组 2 的 29 例患者中 12 例（41%）为良好反应者。根据改良 CT 标准，组 1 的 30 例患者中有 23 例（77%）和组 2 的 29 例患者中有 23 例（79%）为良好反应者。根据改良 CT 标准，两组的良好反应者的肿瘤进展时间明显长于不良反应者（p<0.05）。根据 RECIST 1.1，组 1 的良好反应者的肿瘤进展时间明显长于不良反应者（p=0.0154），但组 2 中无差异。
与仅评估肿瘤大小变化相比，评估 CT 上肿瘤大小和密度变化的治疗反应是预测两组肿瘤进展时间的更好指标。
