中国癌症杂志
中國癌癥雜誌
중국암증잡지
China Oncology
2015年
10期
817-822
,共6页
沈钰新%赵伟新%王升平%陈佳艳%刘笛%蒋国%樊蚊
瀋鈺新%趙偉新%王升平%陳佳豔%劉笛%蔣國%樊蚊
침옥신%조위신%왕승평%진가염%류적%장국%번문
非小细胞肺癌%内皮抑素%CT灌注成像%肿瘤微环境
非小細胞肺癌%內皮抑素%CT灌註成像%腫瘤微環境
비소세포폐암%내피억소%CT관주성상%종류미배경
Non-small cell lung cancer%Endostatin%CT perfusion%Microenvironment
背景与目的：临床数据显示对于局部晚期或晚期非小细胞肺癌(non-small cell lung cancer， NSCLC)，重组人血管内皮抑制素(恩度)联合放疗或化疗较传统化放疗可能更具优势，但其机制，特别是对血管微环境的影响依旧不甚明确。该研究通过CT灌注成像技术(dynamic contrast-enhanced perfusion computed tomography，CT perfusion)对NSCLC肿瘤局部血流灌注进行定量分析，评估恩度单药对NSCLC肿瘤血管微环境的影响。方法：经细胞学或组织学确认的初治ⅢB/Ⅳ期NSCLC患者可入组本研究。全部患者接受7.5 mg?m2恩度单药治疗14 d，于基线期及治疗后分别接受CT灌注成像检查，获取灌注图像并定量分析血流灌注参数：血流量(blood lfow，BF)、血容量(blood volume，BV)以及血管表面通透性(permeability surface，PS)。结果：7例患者(4例为ⅢB期，3例为Ⅳ期)入组，均完成基线期及恩度单药治疗后CT灌注扫描。血流灌注参数BF、BV、PS的中位值于治疗前后分别为27.1/48.9 mL·(100mL·min)-1、86.8/84.8 mL·100 mL-1以及45.0/54.0 mL·(100mL·min)-1。经过14 d恩度单药治疗，肿瘤BF值较治疗前显著上升(P=0.028)，而BV值与PS值变化无统计学意义(BV：P=0.398；PS：P=0.237)。结论：恩度单药治疗局部晚期或晚期NSCLC后，可导致肿瘤局部灌注血流量明显上升而通透性和血容量则变化不明显。
揹景與目的：臨床數據顯示對于跼部晚期或晚期非小細胞肺癌(non-small cell lung cancer， NSCLC)，重組人血管內皮抑製素(恩度)聯閤放療或化療較傳統化放療可能更具優勢，但其機製，特彆是對血管微環境的影響依舊不甚明確。該研究通過CT灌註成像技術(dynamic contrast-enhanced perfusion computed tomography，CT perfusion)對NSCLC腫瘤跼部血流灌註進行定量分析，評估恩度單藥對NSCLC腫瘤血管微環境的影響。方法：經細胞學或組織學確認的初治ⅢB/Ⅳ期NSCLC患者可入組本研究。全部患者接受7.5 mg?m2恩度單藥治療14 d，于基線期及治療後分彆接受CT灌註成像檢查，穫取灌註圖像併定量分析血流灌註參數：血流量(blood lfow，BF)、血容量(blood volume，BV)以及血管錶麵通透性(permeability surface，PS)。結果：7例患者(4例為ⅢB期，3例為Ⅳ期)入組，均完成基線期及恩度單藥治療後CT灌註掃描。血流灌註參數BF、BV、PS的中位值于治療前後分彆為27.1/48.9 mL·(100mL·min)-1、86.8/84.8 mL·100 mL-1以及45.0/54.0 mL·(100mL·min)-1。經過14 d恩度單藥治療，腫瘤BF值較治療前顯著上升(P=0.028)，而BV值與PS值變化無統計學意義(BV：P=0.398；PS：P=0.237)。結論：恩度單藥治療跼部晚期或晚期NSCLC後，可導緻腫瘤跼部灌註血流量明顯上升而通透性和血容量則變化不明顯。
배경여목적：림상수거현시대우국부만기혹만기비소세포폐암(non-small cell lung cancer， NSCLC)，중조인혈관내피억제소(은도)연합방료혹화료교전통화방료가능경구우세，단기궤제，특별시대혈관미배경적영향의구불심명학。해연구통과CT관주성상기술(dynamic contrast-enhanced perfusion computed tomography，CT perfusion)대NSCLC종류국부혈류관주진행정량분석，평고은도단약대NSCLC종류혈관미배경적영향。방법：경세포학혹조직학학인적초치ⅢB/Ⅳ기NSCLC환자가입조본연구。전부환자접수7.5 mg?m2은도단약치료14 d，우기선기급치료후분별접수CT관주성상검사，획취관주도상병정량분석혈류관주삼수：혈류량(blood lfow，BF)、혈용량(blood volume，BV)이급혈관표면통투성(permeability surface，PS)。결과：7례환자(4례위ⅢB기，3례위Ⅳ기)입조，균완성기선기급은도단약치료후CT관주소묘。혈류관주삼수BF、BV、PS적중위치우치료전후분별위27.1/48.9 mL·(100mL·min)-1、86.8/84.8 mL·100 mL-1이급45.0/54.0 mL·(100mL·min)-1。경과14 d은도단약치료，종류BF치교치료전현저상승(P=0.028)，이BV치여PS치변화무통계학의의(BV：P=0.398；PS：P=0.237)。결론：은도단약치료국부만기혹만기NSCLC후，가도치종류국부관주혈류량명현상승이통투성화혈용량칙변화불명현。
Background and purpose:Clinical data show that Endostar, a recombinant human endostatin, has the therapeutic beneift for patients with non-small cell lung cancer (NSCLC) while combined with chemotherapy or ra-diotherapy. However, the microenvironment changes induced by Endostar monotherapy in NSCLC is not yet clear. The purpose of this study was to prospectively study tumor vascular effects of Endostar monotherapy in patients with locally advanced or advanced NSCLC by dynamic contrast-enhanced perfusion computed tomography (CT perfusion, CT-p). Methods:Previously untreated patients with histologically or cytologically conifrmed locally advanced or advanced NSCLC were eligible. All patients received daily Endostar (7.5 mg?m2) for 14 days. CT-p scans were acquired at the baseline and post-treatment. CT-p parameters, such as blood lfow (BF), blood volume (BV) and permeability surface PS (area product), were measured in all patients.Results:Of all 7 patients enrolled, four were staged asⅢB and three as stageⅣ (2 with malignant pleural effusion, 1 with brain metastasis). The median BF, BV and PS values of baseline and post-treatment were 27.1/48.9 mL/100 mL/min, 86.8/84.8 mL/100 mL and 45.0/54.0 mL/100 mL/min, respectively. After administration of Endostar for 14 days , BF showed a signiifcant increase compared with that at baseline (P=0.028), whereas no signiifcant changes were found in BV (P=0.398) and PS (P=0.237) values.Conclusion:Our results suggest that Endostar monotherapy induces a signiifcant increase in BF whereas no signiifcant difference in BV and PS.
