CAJ | 학술논문

目的评估mRECIST标准在评价经动脉化疗栓塞(TACE)联合索拉非尼治疗肝细胞癌疗效中的价值.方法我院2011年6月至2012年11月共有35例采用TACE联合索拉非尼治疗的不可切除肝细胞癌患者符合mRECIST及RECIST疗效评价标准要求.患者影像学复查均采用增强CT和(或)增强MRI检查.评阅35例患者我院联合治疗前基线和治疗后3个月复查的影像学资料,分别使用mRECIST及RECIST标准评价疗效并对两种标准的评价结果进行比较.结果 35例患者RECIST标准评估完全缓解(CR)0％,部分缓解(PR)2.9％,病变稳定(SD) 85.7％,病变进展(PD) 11.4％；mRECIST标准评估CR8.6％,PR 51.4％,SD 34.3％,PD5.7％.RECIST标准评价客观有效率(CR+PR) 2.9％,疾病控制率(CR+ PR+ SD) 88.6％,疾病进展率11.4％；mRECIST标准评价客观有效率60％,疾病控制率94.3％,疾病进展率5.7％.两种标准疗效评价结果差异有统计学意义(P＜0.001).结论 mRECIST标准以“存活肿瘤”对靶病灶进行疗效评价更加可靠,更适应现今TACE和靶向药物等具有新作用机制的治疗方法效果的评估.
목적 평고mRECIST표준재평개경동맥화료전새(TACE)연합색랍비니치료간세포암료효중적개치.방법 아원2011년6월지2012년11월공유35례채용TACE연합색랍비니치료적불가절제간세포암환자부합mRECIST급RECIST료효평개표준요구.환자영상학복사균채용증강CT화(혹)증강MRI검사.평열35례환자아원연합치료전기선화치료후3개월복사적영상학자료,분별사용mRECIST급RECIST표준평개료효병대량충표준적평개결과진행비교.결과 35례환자RECIST표준평고완전완해(CR)0％,부분완해(PR)2.9％,병변은정(SD) 85.7％,병변진전(PD) 11.4％；mRECIST표준평고CR8.6％,PR 51.4％,SD 34.3％,PD5.7％.RECIST표준평개객관유효솔(CR+PR) 2.9％,질병공제솔(CR+ PR+ SD) 88.6％,질병진전솔11.4％；mRECIST표준평개객관유효솔60％,질병공제솔94.3％,질병진전솔5.7％.량충표준료효평개결과차이유통계학의의(P＜0.001).결론 mRECIST표준이“존활종류”대파병조진행료효평개경가가고,경괄응현금TACE화파향약물등구유신작용궤제적치료방법효과적평고.
Objective To evaluate the value of the mRECIST criteria in assessing the efficacy of transcatheter arterial chemoembolization(TACE) combined with sorafenib in the treatment of hepatocellular carcinoma (HCC).Methods A total of 35 patients who were treated with a combination of TACE and sorafenib for unresectable hepatocellular carcinoma fulfilled the mRECIST and RECIST criteria in our hospital from June 2011 to November 2012.Enhanced CT and/or enhanced MRI were used before (baseline) and after (3 month reexamination) combination treatment in our hospital.The mRECIST and RECIST criteria were used to evaluate the efficacy,and these efficacy assessments were compared.Results In the RECIST criteria,complete remission (CR) was 0％,partial remission (PR) was 2.9％,stable disease (SD) was 85.7％％,and progressive disease (PD) was 11.4％％.In the mRECIST criteria,CR was 8.6％,PR was 51.4％,SD was 34.3％,and PD was 5.7％.For the RECIST criteria,the objective response rate (CR+-PR) was 2.9％,the disease control rate (CR+PR+SD) was 88.6％,and the disease progression rate was 11.4％.For the mRECIST criteria,the objective criteria was 60％,the disease control rate was 94.3％,and the disease progression rate was 5.7 ％.The difference between the efficacy assessment results of mRECIST and RECIST was statisti cally significant(P＜0.001).Conclusion The mRECIST criteria can evaluate the efficacy of target le sions based on viable tumors,which is more adaptive to TACE and targeted drugs with new mecha nisms.