Jin Lan, Hu Wuyun, Li Teng, Sun Honghua, Kang Dongxu, Piao Longzhen
Department of Oncology, The Affiliated Hospital of Yanbian University, Yanji, China.
Front Oncol. 2023 Mar 2;13:1015976. doi: 10.3389/fonc.2023.1015976. eCollection 2023.
Irinotecan-loaded drug-eluting beads transarterial chemoembolization (DEBIRI-TACE) is a safe and effective therapeutic option for unresectable colorectal liver metastases (CRLM). The evaluation of treatment response after DEBIRI-TACE is very important for assessing the patient's condition. At present, the Response Evaluation Criteria in Solid Tumors (RECIST) with the tumor size obtained by CT and/or MRI and PET Response Criteria in Solid Tumors (PERCIST) based on fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) are used for evaluating the response to therapy of solid tumors; however, their value in the assessment of treatment response after DEBIRI-TACE remains unclear.
A 52-year-old male with unresectable simultaneous CRLM was treated in the Affiliated Hospital of Yanbian University with DEBIRI-TACE combined with systemic chemotherapy and targeted therapy. Carcinoembryonic antigen levels decreased by 82.50% after 27 days of treatment. At 6 weeks post-surgery, FDG-PET/CT showed that the maximum standardized uptake value (SUVmax) of intrahepatic lesions was reduced to 62.14%. Abdominal MRI revealed that the sum of target lesion diameters was less than 30% that at baseline. PERCIST indicated partial metabolic response, whereas RECIST suggested stable disease.
FDG PET/CT-based PERCIST may be accurate in determining treatment response and evaluating patient prognosis after DEBIRI-TACE in unresectable CRLM.
载有伊立替康的药物洗脱微球经动脉化疗栓塞术（DEBIRI-TACE）是不可切除的结直肠癌肝转移（CRLM）的一种安全有效的治疗选择。DEBIRI-TACE术后治疗反应的评估对于评估患者病情非常重要。目前，实体瘤疗效评价标准（RECIST）通过CT和/或MRI获得肿瘤大小，以及基于氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）的实体瘤PET疗效评价标准（PERCIST）用于评估实体瘤的治疗反应；然而，它们在评估DEBIRI-TACE术后治疗反应中的价值仍不明确。
一名52岁男性患有不可切除的同时性CRLM，在延边大学附属医院接受了DEBIRI-TACE联合全身化疗和靶向治疗。治疗27天后癌胚抗原水平下降了82.50%。术后6周，FDG-PET/CT显示肝内病变的最大标准化摄取值（SUVmax）降至62.14%。腹部MRI显示靶病变直径总和小于基线时的30%。PERCIST提示部分代谢反应，而RECIST提示病情稳定。
基于FDG PET/CT的PERCIST在确定不可切除CRLM患者DEBIRI-TACE术后的治疗反应和评估患者预后方面可能是准确的。
