Yamamichi Junta, Kawaguchi Yasunori, Otsuka Taiga, Nakashita Shunya, Mizobe Hideaki, Eguchi Yuichiro, Kimura Shinya
Medical Equipment Business Planning Department, Medical Systems Operations Canon Inc. Tokyo Japan.
Department of Hepatobiliary and Pancreatology Saga-ken Medical Centre Koseikan Saga Japan.
JGH Open. 2019 Aug 2;4(2):145-152. doi: 10.1002/jgh3.12230. eCollection 2020 Apr.
To better predict patient survival, we used automated tumor volume and density measurements to make an objective radiological assessment of the response of advanced hepatocellular carcinoma (HCC) to treatment with sorafenib.
Patients treated with sorafenib were identified retrospectively. Those who were diagnosed with Child-Pugh class A liver function, Barcelona-Clinic Liver Cancer stage C, and Eastern Cooperative Oncology Group performance status grade 0/1 were enrolled ( = 22). Reviews of contrast-enhanced computed tomography images were supported by the automated measurement of lesions using computer software. Treatment responses were assessed using volume and density criteria. Kaplan-Meier methods and multivariate Cox regression analysis were used to evaluate treatment responses and identify the most significant prognostic factors for overall survival (OS).
After patients were dichotomized according to volume and density criteria, the median OS for those with an objective response (OR) (complete response + partial response) was 20.4 months and that for those with a non-OR (stable disease + progressive disease) was 9.3 months ( = 0.009). The best multivariate regression model for survival identified volume and density criteria (OR or non-OR) as a significant variable, along with baseline alpha-fetoprotein levels (log-rank test, = 0.01). No other conventional criteria were identified as significant.
Tumor volume and density assessment using automated lesion measurements may be an objective method of evaluating responses of advanced HCC to treatment with sorafenib.
为了更好地预测患者生存率，我们使用自动肿瘤体积和密度测量对晚期肝细胞癌（HCC）经索拉非尼治疗后的反应进行客观的影像学评估。
回顾性确定接受索拉非尼治疗的患者。纳入那些被诊断为Child-Pugh A级肝功能、巴塞罗那临床肝癌分期C期且东部肿瘤协作组体能状态评分为0/1级的患者（n = 22）。利用计算机软件对病变进行自动测量，辅助对增强CT图像进行分析。使用体积和密度标准评估治疗反应。采用Kaplan-Meier法和多因素Cox回归分析评估治疗反应，并确定总生存（OS）的最显著预后因素。
根据体积和密度标准将患者分为两组后，有客观反应（OR）（完全缓解+部分缓解）患者的中位OS为20.4个月，无客观反应（非OR，疾病稳定+疾病进展）患者的中位OS为9.3个月（P = 0.009）。生存的最佳多因素回归模型确定体积和密度标准（OR或非OR）以及基线甲胎蛋白水平为显著变量（对数秩检验，P = 0.01）。未发现其他传统标准具有显著性。
利用病变自动测量进行肿瘤体积和密度评估可能是评估晚期HCC对索拉非尼治疗反应的一种客观方法。
