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实体肿瘤治疗的放射学监测实践

Radiological monitoring of the treatment of solid tumors in practice.

作者信息

Ganten M K, Ganten T M, Schlemmer H P

机构信息

Radiology, German Cancer Research Center, Heidelberg.

Gastroenterology, University Hospital Heidelberg.

出版信息

Rofo. 2014 May;186(5):466-73. doi: 10.1055/s-0033-1356329. Epub 2014 Feb 21.

Abstract

PURPOSE

Thanks to advances in cancer therapy, the diagnosis of "incurable cancer" is increasingly able to be changed to a chronic disease that is manageable over long periods, resulting in a change in the clinical management of cancer patients with solid tumors. New parameters are needed to measure the success of targeted therapy in clinical trials.

MATERIALS AND METHODS

Review article on the basis of selective literature research.

RESULTS

In order to assess how well solid tumors respond to treatment, size-based criteria called RECIST (Response Evaluation Criteria in Solid tumors) have been defined. These criteria have been validated in large oncology trials and are currently used most frequently. New molecular therapies often do not - or at least do not immediately - reduce the size of a tumor. Therefore, RECIST evaluation should be critically assessed especially in the case of modern therapies. Any additional available tumor biology information should be considered. In radiology new methods and developments of RECIST have been introduced to better assess the success of targeted therapy.

CONCLUSION

Assessment according to RECIST has been proven for the follow-up of classic tumor therapy. For the monitoring of targeted therapies, new parameters are often required. Therefore, some specific tumor- and therapy-adapted criteria have already been defined to better evaluate treatment success in clinical trials.

摘要

目的

由于癌症治疗的进展,“无法治愈的癌症”诊断越来越多地能够转变为可长期管理的慢性病,这导致实体瘤癌症患者的临床管理发生变化。在临床试验中需要新的参数来衡量靶向治疗的成效。

材料与方法

基于选择性文献研究撰写综述文章。

结果

为了评估实体瘤对治疗的反应程度,已定义了基于大小的标准,即实体瘤疗效评价标准(RECIST)。这些标准已在大型肿瘤学试验中得到验证,目前使用最为频繁。新的分子疗法通常不会——或者至少不会立即——缩小肿瘤大小。因此,尤其是在现代疗法的情况下,应对RECIST评估进行严格审视。应考虑任何额外可用的肿瘤生物学信息。在放射学领域,已引入RECIST的新方法和进展,以更好地评估靶向治疗的成效。

结论

根据RECIST进行评估已被证明适用于经典肿瘤治疗的随访。对于靶向治疗的监测,通常需要新的参数。因此,已经定义了一些特定的、适应肿瘤和治疗的标准,以更好地评估临床试验中的治疗成效。

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