Division of Hemato-Oncology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Korean J Intern Med. 2019 May;34(3):608-617. doi: 10.3904/kjim.2017.063. Epub 2018 Jan 17.
BACKGROUND/AIMS: The Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) or European Organization for Research and Treatment of Cancer (EORTC) criteria are used to assess metabolic tumor responses. However, tumor responses have shown considerable discrepancies between the morphologic criteria (Response Evaluation Criteria in Solid Tumors [RECIST]) and metabolic criteria. We performed this pooled study to compare the RECIST and metabolic criteria in the assessment of tumor responses.
Electronic databases were searched for eligible articles with the terms "RECIST," "PERCIST," or "EORTC criteria." The level of concordance in the tumor responses between the two criteria was estimated using κ statistics.
A total of 216 patients were collected from eight studies comparing the RECIST and EORTC criteria. The agreement of tumor responses between the two criteria was moderate (κ = 0.447). Eighty-six patients (39.8%) showed disagreement: tumor response was upgraded in 70 patients and downgraded in 16 when adopting the EORTC criteria. The EORTC criteria significantly increased the overall response rate (53% vs. 28%, p < 0.0001). The agreement of tumor responses between the RECIST and PERCIST was deemed fair (κ = 0.389). Of 407 patients from nine studies, 181 (44.5%) showed a discrepancy: using the PERCIST, tumor response were upgraded in 151 patients and downgraded in 30. When adopting the PERCIST, the overall response rate was also significantly increased from 30% to 55% (p < 0.0001).
This pooled analysis demonstrates that the concordance of tumor responses between the morphologic criteria and metabolic criteria is not excellent. When adopting the metabolic criteria instead of the RECIST, overall response rates were significantly increased.
背景/目的：正电子发射断层扫描反应标准（PERCIST）或欧洲癌症研究与治疗组织（EORTC）标准用于评估代谢肿瘤反应。然而，肿瘤反应在形态学标准（实体瘤反应评估标准 [RECIST]）和代谢标准之间显示出相当大的差异。我们进行了这项荟萃研究，以比较代谢标准和形态学标准在评估肿瘤反应中的作用。
使用“RECIST”、“PERCIST”或“EORTC 标准”等术语在电子数据库中搜索合格的文章。使用 κ 统计评估两种标准之间肿瘤反应的一致性程度。
从比较 RECIST 和 EORTC 标准的八项研究中共收集了 216 名患者。两种标准之间肿瘤反应的一致性为中度（κ=0.447）。有 86 名患者（39.8%）出现不一致：采用 EORTC 标准时，70 名患者肿瘤反应升级，16 名患者肿瘤反应降级。EORTC 标准显著提高了总缓解率（53%比 28%，p<0.0001）。RECIST 和 PERCIST 之间肿瘤反应的一致性被认为是适度的（κ=0.389）。从九项研究中共有 407 名患者，181 名（44.5%）出现差异：采用 PERCIST 标准时，151 名患者肿瘤反应升级，30 名患者肿瘤反应降级。采用 PERCIST 标准时，总缓解率也从 30%显著提高到 55%（p<0.0001）。
这项荟萃分析表明，形态学标准和代谢标准之间肿瘤反应的一致性并不理想。当采用代谢标准而不是 RECIST 时，总缓解率显著提高。
