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动态对比增强磁共振成像直方图参数可预测接受同步放化疗的晚期食管鳞癌患者的无进展生存期。

Dynamic contrast-enhanced MRI histogram parameters predict progression-free survival in patients with advanced esophageal squamous carcinoma receiving concurrent chemoradiotherapy.

作者信息

Xu Lulu, Ge Xiaolin, Sun Nana, Liu Xisheng

机构信息

Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.

Department of Radiotherapy, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.

出版信息

Acta Radiol. 2020 Oct;61(10):1316-1325. doi: 10.1177/0284185120903139. Epub 2020 Feb 13.

Abstract

BACKGROUND

There is increased interest in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for predicting the outcomes of patients with advanced esophageal cancer.

PURPOSE

To explore whether DCE-MRI histogram parameters can predict 12-month progression-free survival (PFS) in patients with advanced esophageal squamous carcinoma receiving concurrent chemoradiation therapy (CRT).

MATERIAL AND METHODS

This retrospective study enrolled 134 patients with advanced esophageal squamous carcinoma who were receiving CRT. The pre-CRT DCE-MRI histogram parameters (median, mean, SD, skewness, kurtosis, and 10th and 90th percentiles) of K, K, and V were collected. PFS analyses were performed using the Kaplan-Meier method and log-rank tests to compute the survival curves. The significant prognostic predictors among the data characteristics and DCE-MRI parameters were determined using multivariate Cox proportional hazards regression analyses.

RESULTS

There were 65 good responders (PFS ≥ 12 months) and 69 poor responders (PFS < 12 months). The median and mean values of K were higher, and the kurtosis value of K was lower in good responders. The median, mean, and 10th and 90th percentile values of K were higher, and the kurtosis values of K and V were lower in good responders. The PFS of patients aged ≥60 years, a CR effect, or a 10th percentile value of K ≥0.13 was increased ( < 0.001, <0.001, and 0.014, respectively).

CONCLUSION

DCE-MRI histogram parameters can be used to evaluate the response to CRT in patients with advanced esophageal squamous carcinoma. The 10th percentile value of K has significant prognostic value for 12-month PFS.

摘要

背景

动态对比增强磁共振成像(DCE-MRI)在预测晚期食管癌患者预后方面的关注度日益提高。

目的

探讨DCE-MRI直方图参数能否预测接受同步放化疗(CRT)的晚期食管鳞癌患者的12个月无进展生存期(PFS)。

材料与方法

本回顾性研究纳入了134例接受CRT的晚期食管鳞癌患者。收集了CRT前DCE-MRI直方图参数(K、K和V的中位数、均值、标准差、偏度、峰度以及第10和第90百分位数)。采用Kaplan-Meier法和对数秩检验进行PFS分析以计算生存曲线。使用多变量Cox比例风险回归分析确定数据特征和DCE-MRI参数中的显著预后预测因素。

结果

有65例良好缓解者(PFS≥12个月)和69例不良缓解者(PFS<12个月)。良好缓解者中K的中位数和均值较高,K的峰度值较低。良好缓解者中K的中位数、均值以及第10和第90百分位数较高,K和V的峰度值较低。年龄≥60岁、CR效应或K的第10百分位数≥0.13的患者PFS增加(分别为<0.001、<0.001和0.014)。

结论

DCE-MRI直方图参数可用于评估晚期食管鳞癌患者对CRT的反应。K的第10百分位数对12个月PFS具有显著预后价值。

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