Ogasawara Sadahisa, Kanai Fumihiko, Ooka Yoshihiko, Motoyama Tenyu, Suzuki Eiichiro, Tawada Akinobu, Chiba Tetsuhiro, Yokosuka Osamu
Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Hepatol Int. 2013 Jun;7(2):703-13. doi: 10.1007/s12072-013-9425-4. Epub 2013 Feb 12.
Sorafenib induces early vascularity reduction in patients with hepatocellular carcinoma (HCC). We sought to identify differences in radiological assessment approaches and to evaluate their usefulness for the prediction of the initial response to sorafenib.
Forty-eight patients with advanced HCC treated with sorafenib were evaluated by four-phase contrast-enhanced computed tomography. All target lesions were analyzed using the Response Evaluation Criteria in Solid Tumors (RECIST), the EASL criteria, and modified RECIST (mRECIST).
At the initial evaluation at 4-6 weeks, rates of objective response (OR) (including both complete and partial responses), stable disease (SD), and progressive disease (PD) were 2, 71, and 27 %, respectively, according to RECIST; 15, 56, and 29 %, respectively, according to the EASL criteria; and 15, 58, and 27 %, respectively, according to mRECIST. Patients who achieved an OR according to the EASL criteria also achieved an OR according to mRECIST. Patients who achieved an OR according to the EASL criteria or mRECIST had better predicted overall survival (OS) than did patients who achieved SD (p = 0.033 and 0.028, respectively). Patients with SD according to RECIST had different outcomes depending on the response according to enhancement criteria. Patients classified as responders (complete and partial) had better predicted OS than those classified as non-responders (those classified as SD and PD) (p = 0.048).
The enhancement criteria could be useful for prediction of the initial response to sorafenib in patients with HCC. Moreover, mRECIST appears to be simple and convenient.
索拉非尼可使肝细胞癌（HCC）患者早期血管减少。我们试图确定放射学评估方法的差异，并评估其对预测索拉非尼初始反应的有用性。
对48例接受索拉非尼治疗的晚期HCC患者进行了四期对比增强计算机断层扫描评估。使用实体瘤疗效评价标准（RECIST）、欧洲肝脏研究学会（EASL）标准和改良RECIST（mRECIST）对所有靶病变进行分析。
在4 - 6周的初始评估中，根据RECIST标准，客观缓解率（OR）（包括完全缓解和部分缓解）、疾病稳定（SD）和疾病进展（PD）的发生率分别为2%、71%和27%；根据EASL标准分别为15%、56%和29%；根据mRECIST标准分别为15%、58%和27%。根据EASL标准达到OR的患者根据mRECIST标准也达到了OR。根据EASL标准或mRECIST标准达到OR的患者比达到SD的患者具有更好的预测总生存期（OS）（分别为p = 0.033和0.028）。根据RECIST标准为SD的患者根据增强标准的反应有不同的结果。分类为反应者（完全缓解和部分缓解）的患者比分类为无反应者（分类为SD和PD的患者）具有更好的预测OS（p = 0.048）。
增强标准可能有助于预测HCC患者对索拉非尼的初始反应。此外，mRECIST似乎简单方便。
