Hompland Tord, Lund Kjersti V, Ellingsen Christine, Kristensen Gunnar B, Rofstad Einar K
Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Radiother Oncol. 2014 Oct;113(1):132-8. doi: 10.1016/j.radonc.2014.09.011. Epub 2014 Oct 15.
High tumor interstitial fluid pressure (IFP) is associated with poor outcome in locally advanced carcinoma of the uterine cervix. We have recently developed a noninvasive assay of the IFP of tumors, and in this assay, the outward interstitial fluid flow velocity at the tumor surface (v0) is measured by Gd-DTPA-based DCE-MRI and used as a parameter for IFP. Here, we investigated the independent prognostic significance of v0 in cervical cancer patients given cisplatin-based concurrent chemoradiotherapy with curative intent.
The study involved 62 evaluable patients from a cohort of 74 consecutive patients (Stage IB through IIIB) with a median follow-up of 5.5 years.
The actuarial disease-free survival (DFS) and overall survival (OS) at 5 years were 67% and 76%, respectively. Significant associations were found between v0 dichotomized about the median value and DFS and OS, both in the total patient cohort and a subcohort of 40 Stage IIB patients. Multivariate analysis involving stage, tumor volume, lymph node status, and v0 revealed that only v0 provided independent prognostic information about DFS and OS.
This investigation demonstrates a strong, independent prognostic impact of the pretreatment peritumoral fluid flow velocity in cervical cancer.
高肿瘤间质液压力（IFP）与局部晚期宫颈癌的不良预后相关。我们最近开发了一种肿瘤IFP的无创检测方法，在该检测中，通过基于钆喷酸葡胺（Gd-DTPA）的动态对比增强磁共振成像（DCE-MRI）测量肿瘤表面的外向间质液流速（v0），并将其用作IFP的参数。在此，我们研究了v0在接受以顺铂为基础的根治性同步放化疗的宫颈癌患者中的独立预后意义。
该研究纳入了74例连续患者（IB期至IIIB期）中的62例可评估患者，中位随访时间为5.5年。
5年时的无病生存率（DFS）和总生存率（OS）分别为67%和76%。在整个患者队列以及40例IIB期患者的亚组中，v0以中位数为界进行二分后与DFS和OS之间均存在显著相关性。涉及分期、肿瘤体积、淋巴结状态和v0的多变量分析显示，只有v0提供了关于DFS和OS的独立预后信息。
本研究表明，宫颈癌治疗前瘤周液流速具有强大的独立预后影响。
