Background

To evaluate changes in perfusion computed tomography (PCT) parameters induced by treatment with conventional chemotherapy (CCT) alone or with CCT and radiation therapy (RT) in patients with non-small cell lung cancer (NSCLC) and to determine whether these changes correlate with response as defined by the response evaluation criteria in solid tumours version 1.1 (RECIST-1.1).

Methods

Fifty-three patients with a histological diagnosis of NSCLC prospectively underwent PCT of the whole tumour, before/after CCT or before/after CCT and RT. Blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) were compared before and after treatment and with the response as defined by RECIST-1.1. The relationship between changes in the perfusion parameters and in tumour size was also evaluated.

Results

PCT parameters decreased after treatment, significantly for BV (p = 0.002) and MTT (p = 0.027). The 30 patients with partial response had a significant decrease of 21% for BV (p = 0.006) and 17% for MTT (p = 0.031). A non-significant decrease in all perfusion parameters was found in patients with stable disease (p > 0.137). In patients with progressive disease, MTT decreased by 10% (p = 0.465) and the other parameters did not significantly vary (p > 0.809). No significant correlation was found between changes in size and PCT parameters (p > 0.145).

Conclusions

Treatment of NSCLC with platinum derivatives, with or without RT, induces changes in PCT parameters. Partial response is associated with a significant decrease in BV and MTT, attributable to the effect of the treatment on tumour vascularisation.

中文翻译：

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非小细胞肺癌（NSCLC）灌注计算机断层扫描对常规化学疗法和放射疗法的反应评估。

背景

评估非小细胞肺癌（NSCLC）患者单独使用常规化学疗法（CCT）或使用CCT和放射疗法（RT）引起的灌注计算机断层扫描（PCT）参数的变化，并确定这些变化是否与由实体瘤版本1.1（RECIST-1.1）中的反应评估标准定义的反应。

方法

在CCT之前/之后或CCT和RT之前/之后，对53例组织学诊断为NSCLC的患者进行了整个肿瘤的PCT检查。比较治疗前后的血流量（BF），血容量（BV），通透性（PMB）和平均通过时间（MTT），并与RECIST-1.1定义的反应进行比较。还评估了灌注参数的变化与肿瘤大小之间的关系。

结果

治疗后PCT参数降低，对于BV（p  = 0.002）和MTT（p  = 0.027）明显降低。30名部分缓解的患者BV显着降低21％（p  = 0.006），MTT显着降低17％（p  = 0.031）。在疾病稳定的患者中，所有灌注参数均无显着降低（p  > 0.137）。在进行性疾病患者中，MTT降低了10％（p  = 0.465），其他参数没有显着变化（p  > 0.809）。在尺寸变化和PCT参数之间未发现显着相关性（p  > 0.145）。

结论

用铂衍生物在有或无RT的情况下对NSCLC的治疗都会引起PCT参数的变化。部分反应与BV和MTT的显着降低有关，这归因于治疗对肿瘤血管形成的影响。