Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy.
Eur Radiol
; 23(8): 2127-36, 2013 Aug.
Article
em En
| MEDLINE
| ID: mdl-23553586
ABSTRACT
OBJECTIVES:
To determine whether CT can depict early perfusion changes in lung cancer treated by anti-angiogenic drugs, allowing prediction of response.METHODS:
Patients with non-small cell lung cancer, treated by conventional chemotherapy with (Group 1; n = 17) or without (Group 2; n = 23) anti-vascular endothelial growth factor (anti-VEGF) drug (bevacizumab) underwent CT perfusion before (TIME 0) and after 1 (TIME 1), 3 (TIME 2) and 6 (TIME 3) cycles of chemotherapy. The CT parameters evaluated included (1) total tumour vascular volume (TVV) and total tumour extravascular flow (TEF); (2) RECIST (Response Evaluation Criteria in Solid Tumours) measurements. Tumour response was also assessed on the basis of the clinicians' overall evaluation.RESULTS:
In Group 1, significant reduction in perfusion was identified between baseline and (1) TIME 1 (TVV, P = 0.0395; TEF, P = 0.015); (2) TIME 2 (TVV, P = 0.0043; TEF, P < 0.0001); (3) TIME 3 (TVV, P = 0.0034; TEF, P = 0.0005) without any significant change in Group 2. In Group 1 (1) the reduction in TVV at TIME 1 was significantly higher in responders versus non-responders at TIME 2 according to RECIST (P = 0.0128) and overall clinicians' evaluation (P = 0.0079); (2) all responders at TIME 2 had a concurrent decrease in TVV and TEF at TIME 1.CONCLUSION:
Perfusion CT demonstrates early changes in lung cancer vascularity under anti-angiogenic chemotherapy that may help predict therapeutic response. KEY POINTS ⢠Perfusion CT has the potential of providing in vivo information about tumour vasculature. ⢠CT depicts early and specific perfusion changes in NSCLC under anti-angiogenic drugs. ⢠Specific therapeutic effects of anti-angiogenic drugs can be detected before tumour shrinkage. ⢠Early perfusion changes can help predict therapeutic response to anti-angiogenic treatment. ⢠Perfusion CT could be a non-invasive tool to monitor anti-angiogenic treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
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Tomografia Computadorizada por Raios X
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Carcinoma Pulmonar de Células não Pequenas
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Pulmão
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Neoplasias Pulmonares
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article