唑来膦酸治疗期间仅骨转移乳腺癌患者骨闪烁显像评估治疗反应的验证：与计算机断层扫描评估的比较
VALIDATION OF THERAPEUTIC RESPONSE ASSESSMENT BY BONE SCINTIGRAPHY IN PATIENTS WITH BONE-ONLY METASTATIC BREAST CANCERS DURING ZOLEDRONIC ACID TREATMENT: COMPARISON WITH COMPUTED TOMOGRAPHY ASSESSMENT.
作者信息
Ishii Shirou, Kikuchi Ken, Miyajima Masayuki, Sakuma Kotaro, Shishido Fumio
出版信息
Fukushima J Med Sci. 2015;61(1):23-31. doi: 10.5387/fms.2013-15. Epub 2015 May 3.
PURPOSE
To validate the use of bone scintigraphy (BS) versus computed tomography (CT) for therapeutic monitoring in patients during treatment with zoledronic acid.
MATERIALS AND METHODS
Eleven patients with bone-only metastatic disease and being treated with zoledronic acid were included. The effects of therapies including chemotherapy and hormone therapy were evaluated in 25 separate examinations in total as follows: complete response (CR), when no bone metastasis was visible; partial response (PR), when a decrease in the lesion area was detected; stable disease (SD), when no or slight change was observed; and progressive disease (PD), when new or enlarged lesion areas were observed.
RESULTS
The accuracies of examination by Readers 1, 2, and 3 respectively were 76%, 80% and 76% for BS, 52%, 48%, and 40% for CT, and 64%, 52% and 60% for BS and CT combined with Readers 2 and 3 observing significant differences between CT and BS results. The rates of interobserver agreement between Readers 1 and 2, between Readers 1 and 3, and between Reader 2 and 3 respectively, were 84%, 80% and 88% (κ = 0.648, 0.561 and 0.766) for BS, 52%, 56%, and 60% (κ = 0.180, 0.278 and 0.282) for CT, and 52%, 60%, and 56% (κ = 0.215, 0.282 and 0.232) for CT and BS combined.
CONCLUSION
BS is effective for assessing the response of bone metastasis to therapy in patients during zoledronic acid treatment.
目的
验证骨闪烁显像（BS）与计算机断层扫描（CT）在唑来膦酸治疗患者中用于治疗监测的效果。
材料与方法
纳入11例仅患有骨转移疾病且正在接受唑来膦酸治疗的患者。总共在25次单独检查中评估了包括化疗和激素治疗在内的治疗效果，具体如下：完全缓解（CR），即未见骨转移；部分缓解（PR），即检测到病变面积减小；疾病稳定（SD），即未见变化或仅有轻微变化；疾病进展（PD），即观察到新的或扩大的病变区域。
结果
读者1、读者2和读者3进行检查的准确率，BS分别为76%、80%和76%，CT分别为52%、48%和40%，BS与CT联合时分别为64%、52%和60%，读者2和读者3观察到CT与BS结果之间存在显著差异。读者1与读者2之间、读者1与读者3之间以及读者2与读者3之间的观察者间一致性率，BS分别为84%、80%和88%（κ = 0.648、0.561和0.766），CT分别为52%、56%和60%（κ = 0.180、0.278和0.282），CT与BS联合时分别为52%、60%和56%（κ = 0.215、0.282和0.232）。
结论
BS在评估唑来膦酸治疗期间患者骨转移对治疗的反应方面是有效的。
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