Fang W J, Lam K O, Ng S C Y, Choi C W, Kwong D L W, Zheng S S, Lee V H F
First Affiliated Hospital, School of Medicine, Zhe Jiang University, China.
Asian Pac J Cancer Prev. 2013;14(7):4151-5. doi: 10.7314/apjcp.2013.14.7.4151.
To compare response evaluation criteria in solid tumours (RECIST) and volumetric evaluation (VE) for colorectal cancer with liver-limited metastasis.
VE of liver metastases was performed by manual contouring before and after chemotherapy on 45 pairs of computed tomography (CT) images in 36 patients who suffered from metastatic colorectal cancer (mCRC) with liver metastasis only. Cohen kappa was used to compare the agreement between VE and RECIST. Pearson correlation was performed for their comparison after cubic root transformation of the aggregate tumor volumes. Logistic regression was done to identify clinical and radiographic factors to account for the difference which may be predictive in overall response (OR).
There were 16 partial response (PR), 23 stable disease (SD) and 6 progressive disease (PD) cases with VE, and 14 PR, 23 SD and 8 PD with RECIST. VE demonstrated good agreement with RECIST (κ=0.779). Discordant objective responses were noted in 6 pairs of comparisons (13.3%). Pearson correlation also showed excellent correlation between VE and RECIST (r2=0.966, p<0.001). Subgroup analysis showed that VE was in slightly better agreement with RECIST for enlarging lesions than for shrinking lesions (r2=0.935 and r2=0.780 respectively). No factor was found predictive of the difference in OR between VE and RECIST.
VE exhibited good agreement with RECIST. It might be more useful than RECIST in evaluation shrinking lesions in cases of numerous and conglomerate liver metastases.
比较实体瘤疗效评价标准（RECIST）与体积评估（VE）在仅发生肝转移的结直肠癌中的应用。
对36例仅发生肝转移的转移性结直肠癌（mCRC）患者的45对计算机断层扫描（CT）图像进行化疗前后肝脏转移灶的手动轮廓勾画，以进行VE评估。采用Cohen κ检验比较VE与RECIST之间的一致性。对总体肿瘤体积进行立方根转换后，采用Pearson相关性分析进行比较。进行逻辑回归分析以确定可能预测总体反应（OR）差异的临床和影像学因素。
VE评估有16例部分缓解（PR）、23例疾病稳定（SD）和6例疾病进展（PD）；RECIST评估有14例PR、23例SD和8例PD。VE与RECIST显示出良好的一致性（κ=0.779）。在6对比较（13.3%）中观察到客观反应不一致。Pearson相关性分析也显示VE与RECIST之间具有极好的相关性（r2=0.966，p<0.001）。亚组分析表明，对于增大病变，VE与RECIST的一致性略优于缩小病变（分别为r2=0.935和r2=0.780）。未发现可预测VE与RECIST之间OR差异的因素。
VE与RECIST显示出良好的一致性。在评估肝转移灶数目众多且融合的病例中的缩小病变时，VE可能比RECIST更有用。
