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选择性肝内放射治疗后早期代谢反应的存在及无肝外转移对结直肠癌肝转移的预后重要性

Prognostic Importance of the Presence of Early Metabolic Response and Absence of Extrahepatic Metastasis After Selective Internal Radiation Therapy in Colorectal Cancer Liver Metastasis.

作者信息

Soydal Cigdem, Kucuk Nuriye Ozlem, Balci Deniz, Gecim Ethem, Bilgic Sadik, Elhan Atilla Halil

机构信息

1 Department of Nuclear Medicine, Ankara University Medical School , Ankara, Turkey .

2 Department of Surgery, Ankara University Medical School , Ankara, Turkey .

出版信息

Cancer Biother Radiopharm. 2016 Nov;31(9):342-346. doi: 10.1089/cbr.2016.2105.

Abstract

AIMS

In this study, the authors aimed to identify prognostic factors after selective internal radiation therapy (SIRT) for colorectal cancer (CRC) liver metastasis.

METHODS

Forty-nine (28 male, 21 female; mean age: 64.6 ± 10.8) patients who received SIRT for CRC liver metastasis were studied. Effects of number (<5 vs. ≥5), maximum dimension, and standardized uptake value (SUV) of liver metastases, liver tumor load (<25% vs. 26%-50% vs. 51%-75%), presence of extrahepatic disease, and metabolic early response on overall survival were analyzed.

RESULTS

Mean follow-up time was 44.1 ± 27.5 months. Overall survival time was calculated as 10.03 ± 1.61 (95% CI; 6.86-13.20) months. SUV (0.004) of liver metastases, early metabolic response (p = 0.015), and presence of extrahepatic metastasis (p = 0.001) were identified as significant factors influencing overall survival. The hazard ratio was 1:2.3 for the presence of extrahepatic metastasis and 1:2.7 for the absence of early metabolic response.

CONCLUSION

These findings suggest that patients with CRC liver metastasis who have lower SUV at presentation and early metabolic response have better outcomes after SIRT.

摘要

目的

在本研究中,作者旨在确定结直肠癌(CRC)肝转移患者接受选择性内放射治疗(SIRT)后的预后因素。

方法

对49例(28例男性,21例女性;平均年龄:64.6±10.8)接受SIRT治疗的CRC肝转移患者进行研究。分析肝转移灶数量(<5个与≥5个)、最大直径、标准化摄取值(SUV)、肝肿瘤负荷(<25%与26%-50%与51%-75%)、肝外疾病的存在情况以及代谢早期反应对总生存期的影响。

结果

平均随访时间为44.1±27.5个月。总生存时间计算为10.03±1.61(95%CI;6.86-13.20)个月。肝转移灶的SUV(0.004)、早期代谢反应(p=0.015)以及肝外转移的存在(p=0.001)被确定为影响总生存期的显著因素。肝外转移存在时的风险比为1:2.3,无早期代谢反应时的风险比为1:2.7。

结论

这些发现表明,SIRT治疗后,初始SUV较低且有早期代谢反应的CRC肝转移患者预后较好。

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