Dewhirst M W, Sim D A, Wilson S, DeYoung D, Parsells J L
Cancer Res. 1983 Dec;43(12 Pt 1):5735-41.
Most early-phase testing of new therapeutic modalities involves analysis of initial tumor response as opposed to estimation of long-term response. In this study, the validity of initial response rates to predict long-term responses was examined for tumors treated with radiotherapy alone compared with heat combined with radiotherapy. A total of 130 pet animals with either squamous cell carcinomas, melanomas, fibrosarcomas, mammary adenocarcinomas, or mast cell sarcomas were randomized to receive either radiation alone (XRT) or heat + radiation (delta + XRT). Responses to treatment were evaluated by response rates and response duration. The complete response (CR) rates were consistently higher for delta + XRT than for XRT across different histology groups. The combined therapy led to prolonged tumor response in all histological subgroups except melanomas, which had a longer response duration when treated with XRT alone (p = 0.043). This was in spite of a relatively high CR rate in that group (100% versus 12.5% for delta + XRT and XRT, respectively). In contrast, while no significant improvement in CR rate was observed for dermal squamous cell carcinomas treated with delta + XRT (XRT = 52.9%; delta + XRT = 68.8%), a significant improvement in response duration was noted (p = 0.002). These are two examples where CR rate did not predict long-term response. When all histological subgroups were combined (except melanomas), the CR rate was higher (p less than 0.001), and response duration was prolonged (p = 0.031) for delta + XRT compared to XRT alone.
大多数新治疗模式的早期阶段测试涉及对初始肿瘤反应的分析,而非对长期反应的估计。在本研究中,对单独接受放疗与热疗联合放疗的肿瘤,检验了初始反应率预测长期反应的有效性。总共130只患有鳞状细胞癌、黑色素瘤、纤维肉瘤、乳腺腺癌或肥大细胞肉瘤的宠物被随机分配接受单独放疗(XRT)或热疗+放疗(δ+XRT)。通过反应率和反应持续时间评估治疗反应。在不同组织学组中,δ+XRT的完全缓解(CR)率始终高于XRT。联合治疗使除黑色素瘤外的所有组织学亚组的肿瘤反应延长,黑色素瘤单独接受XRT治疗时反应持续时间更长(p = 0.043)。尽管该组的CR率相对较高(δ+XRT和XRT分别为100%和12.5%)。相比之下,虽然接受δ+XRT治疗的皮肤鳞状细胞癌的CR率没有显著提高(XRT = 52.9%;δ+XRT = 68.8%),但反应持续时间有显著改善(p = 0.002)。这是CR率无法预测长期反应的两个例子。当将所有组织学亚组(黑色素瘤除外)合并时,与单独XRT相比,δ+XRT的CR率更高(p小于0.001),反应持续时间延长(p = 0.031)。