Kostek Osman, Yilmaz Erdem, Bekir Hacıoglu Muhammet, Erdogan Bulent, Kodaz Hilmi, Turkmen Bekmez Esma, Hacibekiroglu Ilhan, Uzunoglu Sernaz, Tuncbilek Nermin, Cicin Irfan
Trakya University, School of Medicine, Department of Medical Oncology, Edirne, Turkey.
J BUON. 2018 Jul-Aug;23(4):979-984.
Efficient and adequate evaluation of therapeutic response in hepatocellular carcinoma (HCC) is an evolving field. We aimed to evaluate apparent diffusion coefficient (ADC) values in the prediction of response to sorafenib and prognosis in patients with advanced HCC.
Baseline magnetic resonance (MR) imaging was performed before treatment. After sorafenib started, clinical and radiological response were evaluated at approximately 3 months later. ADC measurements were performed by a 12- year experienced radiologist who evaluated MR before and after sorafenib therapy.
A total of 17 patients (median age 60 years, range 51-66 and M/F ratio=3.25/1) were analyzed. A significant increase in ADC levels in responders was observed 3 months after sorafenib therapy. Baseline and post-sorafenib ADC values were not significantly associated with mortality (hazard ratio/HR baseline ADC=1.003, p=0.98) and after sorafenib (HR 0.480, p=0.48, respectively).
Advanced HCC patients with a favorable response to sorafenib had a significant increase in ADC value at the first radiological evaluation. The predictive and prognostic role of ADC for overall survival is still unknown and further research is needed to investigate any possible association.
对肝细胞癌（HCC）治疗反应进行高效且充分的评估是一个不断发展的领域。我们旨在评估表观扩散系数（ADC）值在预测晚期HCC患者对索拉非尼的反应及预后方面的作用。
在治疗前进行基线磁共振（MR）成像。索拉非尼开始治疗后，大约在3个月后评估临床和影像学反应。ADC测量由一位有12年经验的放射科医生进行，该医生在索拉非尼治疗前后评估MR。
共分析了17例患者（中位年龄60岁，范围51 - 66岁，男/女比例 = 3.25/1）。在索拉非尼治疗3个月后，观察到反应者的ADC水平显著升高。基线和索拉非尼治疗后的ADC值与死亡率均无显著相关性（风险比/HR基线ADC = 1.003，p = 0.98；索拉非尼治疗后HR = 0.480，p = 0.48）。
对索拉非尼反应良好的晚期HCC患者在首次影像学评估时ADC值显著升高。ADC对总生存期的预测和预后作用仍不清楚，需要进一步研究以探讨任何可能的关联。
