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影像学反应对骨肉瘤患者化疗的预后价值。

Prognostic value of radiological response to chemotherapy in patients with osteosarcoma.

机构信息

Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.

出版信息

PLoS One. 2013 Jul 29;8(7):e70015. doi: 10.1371/journal.pone.0070015. Print 2013.

DOI:10.1371/journal.pone.0070015
PMID:23922892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3726455/
Abstract

BACKGROUND

Chemotherapy is essential to improve the prognosis of the patients with osteosarcoma, and the response to chemotherapy is an important prognostic factor. In this study, the impact of various radiological examinations on overall survival (OS) and event-free survival (EFS) was evaluated.

METHOD

Eighty-two patients with high-grade osteosarcoma were included in this study, and we evaluated the following factors for prognostic significance: age (≥40 years), gender (male), tumor location (truncal site), metastatic disease, histological response to chemotherapy, radiological response to chemotherapy assessed using X-ray, angiography, CT, MRI, (201)Tl scintigraphy, and (99m)Tc-MIBI scintigraphy ((99m)Tc-MIBI), and combined radiological score (CRS).

RESULTS

Univariate analyses revealed that metastatic disease, histological response, (99m)Tc-MIBI, and CRS were significantly correlated with OS. Multivariate analyses showed that metastatic disease (OS: HR 35.9, P<0.001; EFS: HR 17.32, P<0.001) was an independent predictor of OS and EFS. Tumor location (HR 36.1, P = 0.003), histological response (HR 31.1, P = 0.036), and (99m)Tc-MIBI (HR 18.4, P = 0.038) were significant prognostic factors for OS. Moreover, CRS was a marginally significant predictor of OS and EFS.

CONCLUSION

The chemotherapeutic effects evaluated by (99m)Tc-MIBI and CRS could be considered as prognostic factors in osteosarcoma.

摘要

背景

化疗对于改善骨肉瘤患者的预后至关重要，而化疗反应是一个重要的预后因素。本研究评估了各种影像学检查对总生存期（OS）和无事件生存期（EFS）的影响。

方法

本研究纳入了 82 例高级别骨肉瘤患者，我们评估了以下因素对预后的意义：年龄（≥40 岁）、性别（男）、肿瘤部位（躯干部位）、转移疾病、组织学化疗反应、使用 X 射线、血管造影、CT、MRI、（201）铊闪烁扫描和（99m）Tc-MIBI 闪烁扫描（（99m）Tc-MIBI）评估的化疗反应，以及综合影像学评分（CRS）。

结果

单因素分析显示，转移疾病、组织学反应、（99m）Tc-MIBI 和 CRS 与 OS 显著相关。多因素分析显示，转移疾病（OS：HR 35.9，P<0.001；EFS：HR 17.32，P<0.001）是 OS 和 EFS 的独立预测因素。肿瘤部位（HR 36.1，P=0.003）、组织学反应（HR 31.1，P=0.036）和（99m）Tc-MIBI（HR 18.4，P=0.038）是 OS 的显著预后因素。此外，CRS 是 OS 和 EFS 的边缘显著预测因素。

结论

（99m）Tc-MIBI 和 CRS 评估的化疗效果可被视为骨肉瘤的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e91/3726455/e46000ee45d4/pone.0070015.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e91/3726455/aafea924b194/pone.0070015.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e91/3726455/e46000ee45d4/pone.0070015.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e91/3726455/aafea924b194/pone.0070015.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e91/3726455/e46000ee45d4/pone.0070015.g002.jpg

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