Greenberg Vladislav, Lazarev Irina, Frank Yigal, Dudnik Julia, Ariad Samuel, Shelef Ilan
Department of Oncology, Soroka University Medical Center (SUMC) and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Department of Radiology, Soroka University Medical Center (SUMC) and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Lung Cancer. 2017 Jun;108:90-95. doi: 10.1016/j.lungcan.2017.02.017. Epub 2017 Mar 6.
Lung cancer typically starts as a near-spherical lesion, but as it grows it may acquire an irregular radiologic formation. RECIST is based on the assumption that tumors are spherical, and consequently, proportional changes of tumor volume and parallel changes in tumor diameter, and vice versa. Hence, a 30% decrease in diameter (2r) implies a 65% decrease of volume, and a 20% increase in diameter implies a 73% increase of volume.
We compared volumetric measurement based on multi-detector CT technology with calculated volume (CV) according to RECIST in a cohort of 43 patients with advanced, non-squamous cell type, lung cancer treated with a combination of platinum and pemetrexed.
CV was larger than SMV in most patients both at baseline and at best overall response (BOR). The difference between the sum of volumes based on volumetric measurement (SMV) and CV was larger for higher sum of diameters. The Lin's concordance correlation coefficient between the percent changes in SMV and CV at BOR was 0.757. Of note, four patients (4/43, 9.5%) were categorized as PD according to the method of CV, but SD according to the method of SMV.
Our study highlights the importance of volumetric measurement for assessing response to treatment in lung cancer patients particularly showing large, irregular lesions.
肺癌通常起始为近球形病变，但随着其生长，可能会呈现不规则的放射学形态。实体瘤疗效评价标准（RECIST）基于肿瘤为球形这一假设，因此，肿瘤体积的比例变化与肿瘤直径的平行变化相互对应，反之亦然。所以，直径（2r）减小30%意味着体积减小65%，直径增加20%意味着体积增加73%。
我们在一组43例接受铂类和培美曲塞联合治疗的晚期非鳞状细胞型肺癌患者中，将基于多排CT技术的体积测量与根据RECIST计算的体积（CV）进行了比较。
在基线和最佳总体缓解（BOR）时，大多数患者的CV均大于标准化摄取值（SMV）。直径总和越高，基于体积测量的体积总和（SMV）与CV之间的差异越大。BOR时SMV和CV百分比变化之间的Lin一致性相关系数为0.757。值得注意的是，4例患者（4/43，9.5%）根据CV方法被分类为疾病进展（PD），但根据SMV方法被分类为疾病稳定（SD）。
我们的研究强调了体积测量在评估肺癌患者治疗反应中的重要性，尤其是对于表现为大的、不规则病变的患者。
