Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2021 Sep 23;11(1):18986. doi: 10.1038/s41598-021-98508-5.
Early prediction of treatment response in nasopharyngeal carcinoma is clinically relevant for optimizing treatment strategies. This meta-analysis was performed to evaluate whether apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) can predict treatment response of patients with nasopharyngeal carcinoma. A systematic search of PubMed-MEDLINE and Embase was performed to identify relevant original articles until July 22, 2021. We included studies which performed DWI for predicting locoregional treatment response in nasopharyngeal carcinoma treated with neoadjuvant chemotherapy, definitive chemoradiation, or radiation therapy. Hazard ratios were meta-analytically pooled using a random-effects model for the pooled estimates of overall survival, local relapse-free survival, distant metastasis-free survival and their 95% CIs. ADC showed a pooled sensitivity of 87% (95% CI 72-94%) and specificity of 70% (95% CI 56-80%) for predicting treatment response. Significant between-study heterogeneity was observed for both pooled sensitivity (I = 68.5%) and specificity (I = 92.2%) (P < 0.01). The pooled hazard ratios of low pretreatment ADC for assessing overall survival, local relapse-free survival, and distant metastasis-free survival were 1.42 (95% CI 1.09-1.85), 2.31 (95% CI 1.42-3.74), and 1.35 (95% CI 1.05-1.74), respectively. In patients with nasopharyngeal carcinoma, pretreatment ADC demonstrated good predictive performance for treatment response.
早期预测鼻咽癌的治疗反应对于优化治疗策略具有重要的临床意义。本荟萃分析旨在评估磁共振弥散加权成像（DWI）的表观弥散系数（ADC）是否可以预测鼻咽癌患者的治疗反应。系统检索了 PubMed-MEDLINE 和 Embase，以确定截至 2021 年 7 月 22 日的相关原始文章。我们纳入了使用 DWI 预测新辅助化疗、根治性放化疗或放疗治疗的鼻咽癌局部区域治疗反应的研究。使用随机效应模型对汇总估计的总生存、局部无复发生存、远处无转移生存及其 95%置信区间进行荟萃分析。ADC 预测治疗反应的敏感性为 87%（95%CI 72%-94%），特异性为 70%（95%CI 56%-80%）。敏感性（I = 68.5%）和特异性（I = 92.2%）的合并荟萃分析均存在显著的异质性（P < 0.01）。低治疗前 ADC 评估总生存、局部无复发生存和远处无转移生存的合并危险比分别为 1.42（95%CI 1.09-1.85）、2.31（95%CI 1.42-3.74）和 1.35（95%CI 1.05-1.74）。在鼻咽癌患者中，治疗前 ADC 对治疗反应具有良好的预测性能。
