血流灌注CT在抗血管生成小分子TKI治疗晚期非小细胞肺癌临床价值  

Exploration of CT perfusion in response prediction in advanced non-small cell Lung cancer who received antiangiogenic tyrosine kinase inhibitors

作　　者：姜保东[1] 王向玲[2] 王健[2] 郝静[2] JIANG Baodong;WANG Xiangling;WANG Jian;HAO Jing(Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, China;Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan 250012, China)

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012 [2]山东大学齐鲁医院肿瘤内科,山东济南250012

出　　处：《医学影像学杂志》2022年第6期949-951,共3页Journal of Medical Imaging

基　　金：山东省济南市科技发展计划基金资助(编号:201805089).

摘　　要：目的探讨血流灌注CT在抗血管生成小分子TKI治疗晚期非小细胞肺癌疗效预测中的价值。方法选取并分析4例晚期非小细胞肺癌患者,抗血管生成小分子TKI治疗前和28天后接受了CT血流灌注显像,评估有效率(RR)和无进展时间(PFS),同时比较肺癌原发病灶血流灌注参数,包括血流量(blood flow,BF)、血容量(blood volume,BV)、对比剂平均通过时间(mean transit time,MTT)的动态变化。结果4例IV期肺腺癌患者,三线接受了阿帕替尼治疗,500 mg,每日一次,2例疗效评价进展(PD),PFS分别为36天和29天;2例疗效评价稳定(SD),PFS分别为175天和345天。所有患者治疗后BF均较基线下降(配对t检验,P=0.088),基线时的BF与PFS显著负相关(Pearson r=-0.9656,P=0.0344)。PD患者BF下降(91.40±2.38 ml/100 ml/min)较SD患者(16.90±6.92 ml/100 ml/min)更显著(t检验,P=0.0095),BF下降程度与PFS呈负相关趋势(Pearson r=-0.8140,P=0.1860)。结论晚期非小细胞肺癌三线接受抗血管生成治疗,基线血流量及血流量的下降幅度与疗效成负相关。Objective To explore the CT perfusion in response prediction in advanced non-small cell Lung cancer who received antiangiogenic tyrosine kinase inhibitors.Methods Four cases of advanced non-small cell lung cancer who received the third line antiangiogenic tyrosine kinase inhibitors were retrospectively analyzed.CT perfusion imaging under went before and 28 days after the first drug dosage.Both tumor response and blood perfusion parameters including blood flow(BF),blood volume(BV)and mean transit time(MTT)were evaluated.Results Four cases were reviewed and all received apatinib(500 mg qd)as third line treatment until progression or intolerable toxicity.On the basis of RECIST criteria,two patients were classified as stable disease(SD),the other 2 as progressive disease(PD).The progression free survival(PFS)was 36,29,175 and 345 days respectively.All cases experienced BF decrease(paired t test,P=0.088).Blood flow at baseline was negatively correlated with PFS(Pearson r=0.9656,P=0.0344).Cases who progressed had greater reduction of BF(91.40±2.38 ml/100 ml/min)than cases with stable disease(16.90±6.92 ml/100 ml/min)after treatment of apatinib,P=0.0095.In addition,BF reduction had a trend to be negatively prognostic of PFS(Pearson r=0.8140,P=0.1860).Conclusion Higher baseline tumor blood flow and reduction after antiangiogenic TKI are correlated with poor response and survival.

关 键 词：非小细胞肺癌 抗血管生成治疗 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]