胃肠道肿瘤新辅助治疗疗效的影像学评价  

Radiological evaluation on the efficacy of neoadjuvant therapy for gastrointestinal tumors

作　　者：张晓鹏[1] 

机构地区：[1]北京大学肿瘤医院北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华胃肠外科杂志》2013年第5期401-405,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家“973”重点基础研究发展计划资助项目（2006CB705706）;国家自然科学基金（81201215）;首都临床特色应用研究（Z121107001012115）

摘　　要：新辅助治疗可使局部进展期胃肠道肿瘤患者增加根治切除的机会并从中获益。影像学是评价新辅助治疗疗效的重要手段．对于胃肠道肿瘤患者实现个体化诊疗意义重大。胃肠道肿瘤新辅助治疗评效的影像学手段主要包括CT、MRI和PET。RECIST形态学标准是目前国际通用的实体肿瘤评效准则，但其在胃肠道癌新辅助化疗的应用却遭遇瓶颈，陷入多数肿瘤无可测量靶病灶的困境。针对上述缺陷，近年来相关研究热点多集中于功能影像学领域，围绕PET和磁共振扩散加权成像的诸多影像学研究已经初步得到振奋人心的成果．有望为胃肠道肿瘤新辅助治疗的疗效评价提供有潜力的新指标。各种影像模式性能的稳定发挥，有赖于影像模式使用过程中的流程标准化、规范化，以保障治疗前后影像学资料较高的可重复性和可对比性。Neoadjuvant therapy can benefit the patients with locally advanced tumors of the gastrointestinal tract through the increase of the likelihood of radical resection. Radiology is the common modalities to evaluate the efficacy of neoadjuvant therapy, which plays an important role in the achievement of the individualized tumor treatment. Radiological modalities in the evaluation of response mainly include CT, MRI, and PET. RECIST is the commonly used criteria internationally in the response evaluation of solid tumors, the value of which is however limited in gastrointestinal tumor due to no measurable target lesion in most circumstances. To overcome the above disadvantage, recent researches have been mainly focusing on functional imaging. There have been primary exciting results in the study of PET and DWI, which have the potential to provide new approaches for the response evaluation of gastrointestinal tumors. The stability of the performance of various radiological modalities depends on the normalization and standardization of the process, through which the reproducibility and comparability between the pre- and post-treatment imaging data is guaranteed.

关 键 词：胃肠肿瘤 新辅助治疗 影像学 疗效评价 

分 类 号：R735[医药卫生—肿瘤]