Trinidad López Carmen, De La Fuente Aguado Javier, Oca Pernas Roque, Delgado Sánchez-Gracián Carlos, Santos Armentia Eloisa, Vaamonde Liste Antonio, Prada González Raquel, Souto Bayarri Miguel
Department of Radiology, POVISA Hospital, 5 Salamanca st, 36208, Vigo, Pontevedra, Spain.
Department of Internal Medicine, POVISA Hospital, Vigo, Spain.
Eur Radiol Exp. 2019 Jun 13;3(1):23. doi: 10.1186/s41747-019-0101-x.
To evaluate changes in perfusion computed tomography (PCT) parameters induced by treatment with conventional chemotherapy (CCT) alone or with CCT and radiation therapy (RT) in patients with non-small cell lung cancer (NSCLC) and to determine whether these changes correlate with response as defined by the response evaluation criteria in solid tumours version 1.1 (RECIST-1.1).
Fifty-three patients with a histological diagnosis of NSCLC prospectively underwent PCT of the whole tumour, before/after CCT or before/after CCT and RT. Blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) were compared before and after treatment and with the response as defined by RECIST-1.1. The relationship between changes in the perfusion parameters and in tumour size was also evaluated.
PCT parameters decreased after treatment, significantly for BV (p = 0.002) and MTT (p = 0.027). The 30 patients with partial response had a significant decrease of 21% for BV (p = 0.006) and 17% for MTT (p = 0.031). A non-significant decrease in all perfusion parameters was found in patients with stable disease (p > 0.137). In patients with progressive disease, MTT decreased by 10% (p = 0.465) and the other parameters did not significantly vary (p > 0.809). No significant correlation was found between changes in size and PCT parameters (p > 0.145).
Treatment of NSCLC with platinum derivatives, with or without RT, induces changes in PCT parameters. Partial response is associated with a significant decrease in BV and MTT, attributable to the effect of the treatment on tumour vascularisation.
评估单纯传统化疗（CCT）或CCT联合放射治疗（RT）对非小细胞肺癌（NSCLC）患者灌注计算机断层扫描（PCT）参数的影响，并确定这些变化是否与实体瘤疗效评价标准第1.1版（RECIST-1.1）所定义的反应相关。
53例经组织学确诊为NSCLC的患者前瞻性地在CCT治疗前后或CCT联合RT治疗前后接受了全肿瘤的PCT检查。比较治疗前后的血流量（BF）、血容量（BV）、通透性（PMB）和平均通过时间（MTT），并与RECIST-1.1所定义的反应进行比较。还评估了灌注参数变化与肿瘤大小变化之间的关系。
治疗后PCT参数降低，BV（p = 0.002）和MTT（p = 0.027）显著降低。30例部分缓解患者的BV显著降低21%（p = 0.006），MTT显著降低17%（p = 0.031）。疾病稳定患者的所有灌注参数均有非显著性降低（p > 0.137）。疾病进展患者的MTT降低10%（p = 0.465），其他参数无显著变化（p > 0.809）。未发现肿瘤大小变化与PCT参数之间存在显著相关性（p > 0.145）。
铂类衍生物治疗NSCLC，无论是否联合RT，均可引起PCT参数变化。部分缓解与BV和MTT的显著降低相关，这归因于治疗对肿瘤血管生成的影响。
