Медицинская литература. Новинки

 

 

 

 

 

 

Метастазы рака молочной железы в печень после химиоэмболизации печеночной артерии: новые критерии оценки объективного ответа

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Цель исследования: разработка критериев оценки эффективности лечения метастазов рака молочной железы в печень методом химиоэмболизации печеночной артерии, основанных на расчете изменения объема опухолевой ткани в метастатических очагах, и сравнение полученных критериев с критериями RECIST Материал и методы. Проанализированы данные компьютерной томографии, проведенной до и после лечения у 21 больной с метастатическим поражением печени. Результаты лечения оценивались для каждого пациента согласно критериям RECIST и показателю кинетики роста опухоли (величина, обратная времени удвоения, RDT). Проводился сравнительный анализ данных объективного ответа, определенного двумя названными способами. Результаты. Отмечены статистически значимые лучшие показатели общей и безрецидивной выживаемости в группе пациентов с объективным ответом по показателю RDT Полученные результаты свидетельствуют о том, что применение критериев RECIST может привести к недооценке объективного ответа на лечение. Выводы. Предложенные критерии ответа, основанные на показателях кинетики роста опухоли, представляются более точными и адекватно отвечающими как характеру морфологических изменений в очаге, так и динамике развития заболевания.

Ключевые слова:
рак молочной железы, метастазы в печень, химиоэмболизация печеночной артерии, компьютерная томография, RECIST, breast cancer, hepatic metastases, transarterial hepatic chemoembolization, computed tomography, RECIST

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Breast Cancer Hepatic Metastases after Transarterial Chemoembolization: the New Objective Response Criteria

Objective: to evaluate the effect of transarterial chemoembolization (TACE) of breast cancer hepatic metastases, based on the calculation of changes in the volume of tumor tissue in metastatic lesions, and comparing this criteria with the RECIST criteria. Materials and methods. CT data of 21 patients with breast cancer metastatic liver lesions before and after treatment was analyzed. Evaluation of the treatment results was made separately for each patient according to RECIST criteria and according to criteria based on the indicator of tumor growth kinetics (reciprocal of doubling time, RDT). Comparative analysis of different criteria was conducted. Results. There was a statistically significant better performance of overall and disease-free survival in patients with an objective response by RDT indicator. The results indicate that the use of RECIST criteria may underestimate the objective response to treatment. Conclusion. The proposed tumor response evaluation criteria, based on the analysis of tumor growth kinetics, proves to be more accurate and respond adequately to the nature of morphological changes in the lesion and to the disease dynamics as well.

Keywords:
рак молочной железы, метастазы в печень, химиоэмболизация печеночной артерии, компьютерная томография, RECIST, breast cancer, hepatic metastases, transarterial hepatic chemoembolization, computed tomography, RECIST