结直肠癌肝转移TACE后疗效评价的RECIST和mRECIST对比研究  

Comparative study of tumor response by RECIST and mRECIST in patients treated with TACE for CRLM

作　　者：华余强[1] 雷蕾[2] 

机构地区：[1]解放军第184医院医学影像科,江西鹰潭335000 [2]解放军第98医院普外科,浙江湖州313000

出　　处：《临床和实验医学杂志》2013年第12期936-939,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的比较实体瘤疗效价标准(RECIST)和改良实体瘤疗效评价标准(mRECIST),为结直肠癌肝脏转移瘤经肝动脉化疗栓塞治疗找到更为合适的疗效评价方法。方法 30例确诊为结直肠癌肝转移接受两次经肝动脉化疗栓塞术(TACE)。术前1周内、治疗后4周患者接受CT或MR三期扫描。根据RECIST和mRECIST标准评价肿瘤缓解程度。两种方法评价结果的比较采用卡方检验。结果据RECIST和mRECIST标准分别评价疗效,达完全缓解、部分缓解、稳定、进展患者例数分别为0、6、17、7例,0、14、9、7例;据两种标准评价治疗的缓解率分别为20.0%和46.7%,差异有统计学意义(P=0.028)。结论 RECIST标准与mRECIST标准相比,低估了结直肠癌肝转移瘤TACE后治疗效果,由于mRECIST标准在测量时强调避开肿瘤液化坏死区域和碘油沉积区域只测量动脉期存活肿瘤,故而对疗效的评价更加准确。Objective To compare RECIST and modified RECIST（mRECIST） criteria in evaluation of patients treated with transarterial chemoembolisation（TACE） for colorectal liver metastases（CRLM）,and choose a more appropriate curative effect evaluation method.Methods Thirty patients with CRLM underwent 2 TACE cycles separated by 30-40 days.Triphasic helical CT or MRI scans were performed at baseline,and at 4 weeks after TACE procedure,and tumor responses were evaluated according to above-mentioned two different criteria.Chi-square test was used to compare the response rate.Results When tumor responses were evaluated using the RECIST and mRECIST criteria,the numbers of the patients achieved complete response,partial response,stable disease,progressive disease were 0,6,17,7;and 0,14,9,7 respectively.The response rates for two different criteria were 20% and 46.7% respectively（p = 0.028）.Conclusion Compared with mRECIST criteria,RECIST criteria underestimate the extent of tumor response after TACE in CRLM.Because mRECIST standards emphasize to avoid tumor necrosis areas and iodine oil deposition area,and only measures viable tumor,mRECIST criteria are more accurate for curative effect evaluation.

关 键 词：结直肠癌肝转移 经动脉灌注化疗栓塞术 实体瘤疗效评价标准 改良实体瘤疗效评价标准 疗效评价 

分 类 号：R735.7[医药卫生—肿瘤]