通过治疗前扩散加权磁共振成像对鼻咽癌诱导化疗反应进行早期评估。
Early assessment of induction chemotherapy response of nasopharyngeal carcinoma by pretreatment diffusion-weighted magnetic resonance imaging.
作者信息
Zheng Dechun, Chen Yunbin, Chen Ying, Xu Luying, Lin Fengjie, Lin Jin, Huang Chaobin, Pan Jianji
机构信息
From the Departments of *Radiology, and †Radiation Oncology, Fujian Provincial Cancer Hospital and Institute, Fuzhou, Fujian, People's Republic of China.
出版信息
J Comput Assist Tomogr. 2013 Sep-Oct;37(5):673-80. doi: 10.1097/RCT.0b013e31829a2599.
OBJECTIVES
This study aimed to evaluate the feasibility of pretreatment diffusion-weighted imaging in predicting response after induction chemotherapy (IC) in nasopharyngeal carcinoma (NPC).
METHODS
Fifty-four patients with stage III and IV NPC underwent MRI examination at baseline, after 2 cycles of chemotherapy, and at the end of chemoradiotherapy. Apparent diffusion coefficient (ADC) values were compared between effective and ineffective subjects after IC.
RESULTS
Mean ADC in effective groups was significantly (P < 0.05) higher than that in the ineffective group. Average and minimum ADCs demonstrated higher sensitivity than maximum ADC for predicting IC response, with 68.4%, 71.1%, and 50.0%, respectively, at an equivalent 68.7% specificity. We observed negative correlations between pretreatment ADC and tumor regression after chemotherapy (γ = - 0.425, P = 0.001) and after chemoradiotherapy (γ = - 0.418, P = 0.003).
CONCLUSIONS
Pretreatment ADC was a valuable biomarker for predicting IC response of NPC. Noninvasive diffusion-weighted imaging provides additional indicator in guiding optical therapeutic options for patients with NPC.
目的
本研究旨在评估鼻咽癌（NPC）诱导化疗（IC）前弥散加权成像预测疗效的可行性。
方法
54例Ⅲ期和Ⅳ期NPC患者在基线、2周期化疗后及放化疗结束时接受MRI检查。比较IC后有效和无效患者的表观扩散系数（ADC）值。
结果
有效组的平均ADC显著高于无效组（P < 0.05）。预测IC疗效时，平均ADC和最小ADC的敏感性高于最大ADC，特异性均为68.7%时，其敏感性分别为68.4%、71.1%和50.0%。我们观察到化疗前ADC与化疗后（γ = - 0.425，P = 0.001）及放化疗后（γ = - 0.418，P = 0.003）肿瘤退缩呈负相关。
结论
化疗前ADC是预测NPC患者IC疗效的有价值生物标志物。无创弥散加权成像为指导NPC患者的优化治疗方案提供了额外指标。
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