McDonald Rachel, Probyn Linda, Poon Ian, Erler Darby, Brotherston Drew, Soliman Hany, Cheung Patrick, Chung Hans, Chu William, Loblaw Andrew, Thavarajah Nemica, Lang Catherine, Chin Lee, Chow Edward, Sahgal Arjun
Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 2015 Nov 15;93(4):879-81. doi: 10.1016/j.ijrobp.2015.07.2288. Epub 2015 Oct 19.
To evaluate the applicability of the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and University of Texas MD Anderson (MDA) Cancer Center criteria in the setting of stereotactic body radiation therapy (SBRT) to nonspine bone metastases.
Patients who were treated with SBRT to nonspine bone metastases were identified by retrospective chart review. An independent musculoskeletal radiologist evaluated response to treatment using computed tomography (CT) scans.
Thirty-three patients were treated to 42 nonspine bone metastases. The most common primary cancer cites were renal cell carcinoma (RCC) (33.3%), lung (24.2%), and prostate (18.2%). Bone metastases were either mainly lytic (57.1%), mainly sclerotic (28.6%), or mixed (14.3%). When lytic and sclerotic lesions were evaluated according to RECIST 1.1, local control (LC) was 83%, 85%, 88%, and 80% for those with CT imaging between months 1 to 3, 4 to 6, 7 to 9, and 10 to 12, respectively. When evaluated by the MDA criteria by density, LC within each time period was slightly greater. Overall LC decreased considerably when evaluated by MDA in terms of size.
Consensus definitions of response are required as they have implications on clinical trials and disease management. Without consistent response criteria, outcomes from clinical trials cannot be compared and treatment efficacy remains undetermined.
评估实体瘤疗效评价标准（RECIST 1.1）和德克萨斯大学MD安德森癌症中心（MDA）标准在立体定向体部放射治疗（SBRT）用于非脊柱骨转移瘤时的适用性。
通过回顾性病历审查确定接受SBRT治疗非脊柱骨转移瘤的患者。一名独立的肌肉骨骼放射科医生使用计算机断层扫描（CT）扫描评估治疗反应。
33例患者接受了针对42处非脊柱骨转移瘤的治疗。最常见的原发癌部位是肾细胞癌（RCC）（33.3%）、肺癌（24.2%）和前列腺癌（18.2%）。骨转移瘤主要为溶骨性（57.1%）、主要为硬化性（28.6%）或混合性（14.3%）。当根据RECIST 1.1评估溶骨性和硬化性病变时，在第1至3个月、4至6个月、7至9个月和10至12个月进行CT成像的患者的局部控制（LC）分别为83%、85%、88%和80%。当根据MDA密度标准评估时，每个时间段内的LC略高。当根据MDA大小标准评估时，总体LC显著下降。
需要对反应的共识定义，因为它们对临床试验和疾病管理有影响。没有一致的反应标准，临床试验的结果就无法比较，治疗效果也无法确定。
