Wiatr E, Wiechecka A, Pawlicka L, Bestry I, Roszkowski K, Szopiński J, Szczepek B, Rowińska-Zakrzewska E
III Kliniki Gruźlicy i Chorób Płuc, Instytutu Gruźlicy i Chorób Płuc w Warszawie.
Pneumonol Alergol Pol. 1996;64(1-2):32-9.
The aim of the study was to assess how objective is the estimation of the chest lesions regression on RT picture and how extent chest CT can increase the precision of this assessment. The material consisted of 66 SCLC pts observed in the Institute of Tuberculosis and Lung Diseases in Warsaw between 1987 and 1994 in whom RT and CT were performed to estimate the degree of response to treatment. Chest RT were estimated by 4 specialists independently. In 28 cases (42%) opinion concerning the degree of tumor regression was the same. In 23 cases (35%) the opinions were discordant and in 15 cases (13%) (mainly after chest irradiation) all examiners agreed that degree of response is impossible to precise (it ranged between PR and CR). In the second part of this study the degree of cancer regression was assessed in the same patients by 2 specialists independently estimated CT pictures. Opinions were different only in 4 cases. The comparison between these two methods was done. CI examination allowed exact estimation of response degree in 20 out of 24 pts (83%) in whom this assessment was impossible using chest radiography. In 9 cases (21%) the assessment of chest CT changed the previous estimation made using chest radiography (in 5 cases from CR to PR and in 4 cases from PR to CR). In conclusion-estimation of tumor regression using chest RT is very subjective method and many errors are possible. Chest CT estimation is a much better method for estimation of tumor response especially in irradiated patients.
本研究的目的是评估在放疗图像上对胸部病变消退的估计有多客观,以及胸部CT能在多大程度上提高这种评估的准确性。研究材料包括1987年至1994年期间在华沙结核病和肺病研究所观察的66例小细胞肺癌患者,对他们进行了放疗和CT检查以评估治疗反应程度。4位专家独立评估胸部放疗情况。28例(42%)关于肿瘤消退程度的意见一致。23例(35%)意见不一致,15例(13%)(主要在胸部照射后)所有检查者都认为无法精确判断反应程度(范围在部分缓解和完全缓解之间)。在本研究的第二部分,由2位专家独立评估同一患者的CT图像来评估癌症消退程度。仅4例意见不同。对这两种方法进行了比较。CT检查能够对24例患者中的20例(83%)准确估计反应程度,而使用胸部X线摄影无法进行这种评估。9例(21%)中,胸部CT的评估改变了之前使用胸部X线摄影做出的估计(5例从完全缓解变为部分缓解,4例从部分缓解变为完全缓解)。总之,使用胸部放疗评估肿瘤消退是一种非常主观的方法,可能会出现很多错误。胸部CT评估是评估肿瘤反应的更好方法,尤其是对于接受过照射的患者。