Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands.
Clin Cancer Res. 2015 Feb 1;21(3):577-84. doi: 10.1158/1078-0432.CCR-14-0736. Epub 2014 Dec 3.
Diffuse optical spectroscopy (DOS) has the potential to enable monitoring of tumor response during chemotherapy, particularly in the early stages of treatment. This study aims to assess feasibility of DOS for monitoring treatment response in HER2-negative breast cancer patients receiving neoadjuvant chemotherapy (NAC) and compare DOS with tumor response assessment by MRI.
Patients received NAC in six cycles of 3 weeks. In addition to standard treatment monitoring by dynamic contrast enhanced MRI (DCE-MRI), DOS scans were acquired after the first, third, and last cycle of chemotherapy. The primary goal was to assess feasibility of DOS for early assessment of tumor response. The predictive value of DOS and DCE-MRI compared with pathologic response was assessed.
Of the 22 patients, 18 patients had a partial or complete tumor response at pathologic examination, whereas 4 patients were nonresponders. As early as after the first chemotherapy cycle, a significant difference between responders and nonresponders was found using DOS (HbO2 86% ± 25 vs. 136% ± 25, P = 0.023). The differences between responders and nonresponders continued during treatment (halfway treatment, HbO2 68% ± 22 vs. 110% ± 10, P = 0.010). Using DCE-MRI, a difference between responders and nonresponders was found halfway treatment (P = 0.005) using tumor volume measurement calculations.
DOS allows for tumor response assessment and is able to differentiate between responders and nonresponders after the first chemotherapy cycle and halfway treatment. In this study, DOS was equally effective in predicting tumor response halfway treatment compared with DCE-MRI. Therefore, DOS may be used as a novel imaging modality for (early) treatment monitoring of NAC.
漫射光学光谱（DOS）有可能实现对肿瘤对化疗的反应进行监测，尤其是在治疗的早期阶段。本研究旨在评估 DOS 用于监测接受新辅助化疗（NAC）的 HER2 阴性乳腺癌患者治疗反应的可行性，并比较 DOS 与 MRI 对肿瘤反应评估的效果。
患者接受 6 个 3 周周期的 NAC。除了通过动态对比增强 MRI（DCE-MRI）进行标准治疗监测外，还在化疗的第一、第三和最后一个周期后获取 DOS 扫描。主要目标是评估 DOS 早期评估肿瘤反应的可行性。评估 DOS 和 DCE-MRI 与病理反应的预测价值。
在 22 名患者中，18 名患者在病理检查时出现部分或完全肿瘤反应，而 4 名患者无反应。早在第一次化疗周期后，使用 DOS 就发现了反应者和无反应者之间的显著差异（HbO2 86%±25 对 136%±25，P=0.023）。在治疗过程中，反应者和无反应者之间的差异继续存在（治疗中途，HbO2 68%±22 对 110%±10，P=0.010）。使用 DCE-MRI，通过肿瘤体积测量计算，在治疗中途发现了反应者和无反应者之间的差异（P=0.005）。
DOS 允许评估肿瘤反应，并能够在第一次化疗周期和治疗中途区分反应者和无反应者。在这项研究中，DOS 在预测治疗中途的肿瘤反应方面与 DCE-MRI 同样有效。因此，DOS 可能成为 NAC （早期）治疗监测的新型成像方式。
