Chen Chao, Dong Hao, Shou Chunhui, Shi Xiaoxiao, Zhang Qing, Liu Xiaosun, Zhu Kankai, Zhong Baishu, Yu Jiren
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Cancer Manag Res. 2020 Feb 3;12:759-768. doi: 10.2147/CMAR.S231636. eCollection 2020.
To investigate the feasibility and utility of computer tomography (CT) volumetry in evaluating the tumor response to neoadjuvant chemotherapy (NAC) in advanced gastric cancer (AGC) patients.
One hundred and seventeen Patients with AGC who received NAC followed by R0 resection between January 2006 and December 2012 were included. Tumor volumes were quantified using OsiriX software. The volume reduction rate (VRR) was calculated as follows: VRR = [(pre-chemotherapy total volume) - (post-chemotherapy total volume)]/(pre-chemotherapy total volume) × 100%. The optimal cut-off VRR for differentiating favorable from unfavorable prognosis was determined by receiver operating characteristic (ROC) analysis. Overall survival was calculated using Kaplan-Meier analysis and values were compared using the Log-rank test. Multivariate analysis was determined by the Cox proportional regression model.
The optimal cut-off VRR was 31.95% according to ROC analysis, with a sensitivity of 70.4% and a specificity of 71.7%. Based on the cut-off VRR, patients were divided into the VRR-High (VRR ≥ 31.95%, n = 63) and VRR-Low (VRR < 31.95%, n = 54) groups. The VRR-Low group exhibited a worse prognosis than that of the VRR-High group (HR, 2.85; 95% CI, 1.69-4.82, P < 0.001), with 3-year survival rates of 40.7% and 79.4%, and 5-year survival rates of 31.5% and 63.5%, respectively.
CT volumetry is a feasible and reliable method for assessing the tumor response to NAC in patients with AGC.
探讨计算机断层扫描（CT）容积测量法在评估晚期胃癌（AGC）患者新辅助化疗（NAC）疗效方面的可行性和实用性。
纳入2006年1月至2012年12月期间接受NAC并随后进行R0切除的117例AGC患者。使用OsiriX软件对肿瘤体积进行量化。体积缩小率（VRR）计算如下：VRR = [（化疗前总体积）-（化疗后总体积）]/（化疗前总体积）×100%。通过受试者工作特征（ROC）分析确定区分预后良好与不良的最佳临界VRR。采用Kaplan-Meier分析计算总生存期，并使用对数秩检验比较数值。通过Cox比例回归模型进行多因素分析。
根据ROC分析，最佳临界VRR为31.95%，敏感性为70.4%，特异性为71.7%。基于临界VRR，患者被分为VRR高组（VRR≥31.95%，n = 63）和VRR低组（VRR < 31.95%，n = 54）。VRR低组的预后比VRR高组差（HR，2.85；95%CI，1.69 - 4.82，P < 0.001），3年生存率分别为40.7%和79.4%，5年生存率分别为31.5%和63.5%。
CT容积测量法是评估AGC患者对NAC疗效的一种可行且可靠的方法。
