Wen Shu Wen, Everitt Sarah J, Bedő Justin, Chabrot Marine, Ball David L, Solomon Benjamin, MacManus Michael, Hicks Rodney J, Möller Andreas, Leimgruber Antoine
Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
Department of Radiation Oncology, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
PLoS One. 2015 Nov 24;10(11):e0142608. doi: 10.1371/journal.pone.0142608. eCollection 2015.
There is renewed interest in the immune regulatory role of the spleen in oncology. To date, very few studies have examined macroscopic variations of splenic volume in the setting of cancer, prior to or during therapy, especially in humans. Changes in splenic volume may be associated with changes in splenic function. The purpose of this study was to investigate variations in spleen volume in NSCLC patients during chemo-radiotherapy. Sixty patients with stage I-IIIB NSCLC underwent radiotherapy (60 Gy/30 fractions) for six weeks with concomitant carboplatin/paclitaxel (Ca/P; n = 32) or cisplatin/etoposide (Ci/E; n = 28). A baseline PET/CT scan was performed within 2 weeks prior to treatment and during Weeks 2 and 4 of chemo-radiotherapy. Spleen volume was measured by contouring all CT slices. Significant macroscopic changes in splenic volume occurred early after the commencement of treatment. A significant decrease in spleen volume was observed for 66% of Ca/P and 79% of Ci/E patients between baseline and Week 2. Spleen volume was decreased by 14.2% for Ca/P (p<0.001) and 19.3% for Ci/E (p<0.001) patients. By Week 4, spleen volume was still significantly decreased for Ca/P patients compared to baseline, while for Ci/E patients, spleen volume returned to above baseline levels. This is the first report demonstrating macroscopic changes in the spleen in NSCLC patients undergoing radical chemo-radiotherapy that can be visualized by non-invasive imaging.
脾脏在肿瘤学中的免疫调节作用再次引起了人们的关注。迄今为止，很少有研究在癌症治疗前或治疗期间，特别是在人类中，研究癌症背景下脾脏体积的宏观变化。脾脏体积的变化可能与脾脏功能的变化有关。本研究的目的是调查非小细胞肺癌（NSCLC）患者在放化疗期间脾脏体积的变化。60例I-IIIB期NSCLC患者接受了为期六周的放疗（60 Gy/30次分割），同时使用卡铂/紫杉醇（Ca/P；n = 32）或顺铂/依托泊苷（Ci/E；n = 28）。在治疗前2周内以及放化疗的第2周和第4周进行了基线PET/CT扫描。通过勾勒所有CT切片来测量脾脏体积。治疗开始后早期脾脏体积出现了显著的宏观变化。在基线和第2周之间，66%的Ca/P患者和79%的Ci/E患者脾脏体积显著减小。Ca/P患者的脾脏体积减小了14.2%（p<0.001），Ci/E患者的脾脏体积减小了19.3%（p<0.001）。到第4周时，与基线相比，Ca/P患者的脾脏体积仍显著减小，而Ci/E患者的脾脏体积恢复到基线以上水平。这是第一份报告，证明了接受根治性放化疗的NSCLC患者脾脏的宏观变化可以通过无创成像观察到。
