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World Journal of Clinical Cases 2024年第2期12卷 285-292页

作者： Sha-Sha Sun Xiao-Di Guo Wen-Dong Li Jing-Long Chen Department of Oncology Capital Medical University Affiliated Beijing Ditan HospitalBeijing 100015China

BACKGROUND Recently,combination therapy has shown a better trend towards improved tumour response and survival outcomes than monotherapy in patients with hepatocellular carcinoma(HCC).However,research on triple therapy[lenvatinib+sintilimab+transarterial chemoembolization(TACE)]as a first-line treatment for advanced HCC is limited.AIM To evaluate the safety and efficacy of triple therapy as a first-line treatment for advanced HCC.METHODS HCC patients with Barcelona Clinic Liver Cancer stage C treated with triple therapy were enrolled.All patients were treated with lenvatinib every day and sintilimab once every 3 wk.Moreover,TACE was performed every 4-6 wk if necessary.The primary outcome of the study was overall survival(OS).The secondary outcomes were the objective response rate(ORR),disease control rate(DCR),and incidence of adverse events.RESULTS Forty HCC patients who underwent triple therapy were retrospectively analysed from January 2019 to January 2022.With a median follow-up of 8.5 months,the 3-,6-,and 12-mo OS rates were 100%,88.5%,and 22.5%,respectively.The ORR and DCR were 45%and 90%,respectively.The median progressive free survival and median OS were not reached.Common complications were observed in 76%of the patients(grade 3,15%;grade 4,2.5%).CONCLUSION Combination therapy comprising lenvatinib,sintilimab and TACE achieved promising outcomes in advanced HCC patients and had manageable effects.

关键词： Lenvatinib Sintilimab Advanced hepatocellular carcinoma Combination therapy tumor response

Comparative study between Embosphere®and Marine gel®as embolic agents for chemoembolization of hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 102-109页

作者： Hyo-Cheol Kim Jin Woo Choi Department of Radiology Seoul National University HospitalSeoul 03080South Korea

BACKGROUND While gelatin sponge particles and calibrated microspheres are commonly used as embolic materials in conventional transarterial chemoembolization(cTACE),direct comparisons between these embolic agents are rare.AIM To compare the efficacy and safety of superselective cTACE using Embosphere®or Marine gel®in patients with early-stage hepatocellular carcinoma(HCC).METHODS This retrospective study included 70 patients with small(tumor response,procedure-related complications,and local tumor recurrence.The primary index tumor was assessed on a 1-mo follow-up image,and local progression-free survival was obtained using the Kaplan-Meier method and was compared by the log-rank test.RESULTS The median tumor size of both groups was 1.5 cm,and 69 patients achieved a complete response one month after cTACE.The cumulative local recurrence rate at 12 mo was 15.5%in the Embosphere®group and 14.4%in the Marine gel®group.The local progression-free survival was not significantly different between the two groups(P=0.83).In the multivariate analysis,high serum alphafetoprotein was the only significant poor prognostic factor for local tumor progression(P=0.01).Postembolization syndrome occurred in 36.4%of the Embosphere®group and 35.1%of the Marine gel®group,and there were no cases of biloma,biliary duct dilation,or liver abscess in either group.CONCLUSION Calibrated gelatin sponge particles(Marine gel®)and calibrated microspheres(Embosphere®)have similar outcomes in terms of tumor response for superselective cTACE of small HCC.

关键词： Hepatocellular carcinoma Chemoembolization Temporary embolic material Permanent embolic material tumor response

Comparison of RECIST version 1.0 and 1.1 in assessment of tumor response by computed tomography in advanced gastric cancer

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Chinese Journal of Cancer Research 2013年第6期25卷 689-694页

作者： Gil-Su Jang Min-Jeong Kim Hong-Il Ha Jung Han Kim Hyeong Su Kim Sung Bae Ju Dae Young Zang Department of Internal Medicine Hallym University Sacred Heart Hospital Department of Diagnostic Radiology Hallym University Sacred Heart Hospital Department of Internal Medicine Kangnam Sacred Heart Hospital

Objective： response Evaluation Criteria in Solid tumors （RECIST） guideline version 1.0 （RECIST 1.0） was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure. With a number of issues being raised on RECIST 1.0, however, a revised RECIST guideline version 1.1 （RECIST 1.1） was proposed by the RECIST Working Group in 2009. This study was conducted to compare CT tumor response based on RECIST 1.1 vs. RECIST 1.0 in patients with advanced gastric cancer （AGC）. Methods： We reviewed 61 AGC patients with measurable diseases by RECIST 1.0 who were enrolled in other clinical trials between 2008 and 2010. These patients were retrospectively re-analyzed to determine the concordance between the two response criteria using the κ statistic. Results： The number and sum of tumor diameters of the target lesions by RECIST 1.1 were significantly lower than those by RECIST 1.0 （P〈0.0001）. However, there was excellent agreement in tumor response between RECIST 1.1 and RECIST 1.0 0（κ=0.844）. The overall response rates （ORRs） according to RECIST 1.0 and RECIST 1.1 were 32.7% （20/61） and 34.5% （20/58）, respectively. One patient with partial response （PR） based on RECIST 1.0 was reclassified as stable disease （SD） by RECIST 1.1. Of two patients with SD by RECIST 1.0, one was downgraded to progressive disease and the other was upgraded to PR by RECIST 1.1. Conclusions： RECIST 1.1 provided almost perfect agreement with RECIST 1.0 in the CT assessment of tumor response of AGC.

关键词： response Evaluation Criteria in Solid tumors guideline version 1.0 （RECIST 1.0） responseEvaluation Criteria in Solid tumors guideline version 1.1 （RECIST 1.1） gastric cancer tumor response

Transarterial chemoembolization using degradable starch microspheres and iodized oil in the treatment of advanced hepatocellular carcinoma: evaluation of tumor response, toxicity, and survival

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Hepatobiliary & Pancreatic Diseases International 2007年第3期6卷 259-266页

作者： Timm D Kirchhoff Joerg S Bleck Arne Dettmer Ajay Chavan Herbert Rosenthal Sonja Merkesdal Bernd Frericks Lars Zender Nisar P Malek Tim F Greten Stefan Kubicka Michael P Manns Michael Galanski Department of Diagnostic Radiology Hannover Medical School Germany Department of Gastroenterology Hepatology and Endocrinology Hannover Medical School Germany Department of Diagnostic and Interventional Radiology Klinikum Oldenburg Germany Division of Rheumatology Hannover Medical School Germany Department of Radiology and Nuclear Medicine Campus B.F-Charité-University Medicine Berlin Germany

BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All complications

关键词： carcinoma, hepatocellular transarterial chemoembolization degradable starch microspheres Lipiodol tumor response survival

Organ-specific efficacy in advanced non-small cell lung cancer patients treated with first-line single-agent immune checkpoint inhibitors

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Chinese Medical Journal 2022年第12期135卷 1404-1413页

作者： Jiayi Deng Ming Gao Qing Gou Chongrui Xu Honghong Yan Mingyi Yang Jiakang Li Xiaorong Yang Xuewu Wei Qing Zhou School of Medicine South China University of TechnologyGuangzhouGuangdong 511400China Guangdong Lung Cancer Institute Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouGuangdong 510080China The Second School of Clinical Medicine Southern Medical UniversityGuangzhouGuangdong 510515China

Background:response to immune checkpoint inhibitors(ICIs)is affected by multiple factors.This study aimed to explore whether sites of metastasis are associated with clinical outcomes of ICIs in advanced non-small-cell lung cancer(NSCLC)patients.Methods::The data of NSCLC patients with high programmed death-ligand 1 expression and good performance status receiving first-line ICIs monotherapy from Guangdong Provincial People’s Hospital between May 2019 and July 2020 were retrospectively analyzed.Metastatic sites included liver,bone,brain,adrenal gland,pleura,and contralateral lung.Progression-free survival(PFS)and overall survival(OS)were compared between different metastatic sites and metastatic burden by the Kaplan-Meier method.Organ-specific disease control rate(OSDCR)of different individual metastatic sites was evaluated.Results:Forty NSCLC patients meeting the criteria were identified.The presence of liver metastasis was significantly associated with shorter PFS(3.1 vs.15.5 months,P=0.0005)and OS(11.1 months vs.not reached,P=0.0016).Besides,patients with bone metastasis tend to get shorter PFS(4.2 vs.15.5 months,P=0.0532)rather than OS(P=0.6086).Moreover,the application of local treatment could numerically prolong PFS in patients with brain metastasis(15.5 vs.4.3 months,P=0.1894).More metastatic organs involved were associated with inferior PFS(P=0.0052)but not OS(P=0.0791).The presence of liver metastasis or bone metastasis was associated with more metastatic organs(Phi[φ]:0.516,P=0.001).The highest OSDCR was observed in lung(15/17),and the lowest in the liver(1/4).Conclusions:Metastases in different anatomical locations may be associated with different clinical outcomes and local tumor response to ICIs in NSCLC.ICIs monotherapy shows limited efficacy in patients with liver and bone metastasis,thus patients with this type of metastasis might require more aggressive combination strategies.

关键词： Metastatic sites Immunotherapy Liver metastases Bone metastasis Non-small-cell lung cancer tumor response

Quantitative dual-energy computed tomography texture analysis predicts the response of primary small hepatocellular carcinoma to radiofrequency ablation

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Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 569-576页

作者： Jin-Ping Li Sheng Zhao Hui-Jie Jiang Hao Jiang Lin-Han Zhang Zhong-Xing Shi Ting-Ting Fan Song Wang Department of Radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China Department of Nuclear Medicine the First Affiliated Hospital of Harbin Medical UniversityHarbin 150086China Department of Radiology Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai 200032China

Background:Radiofrequency ablation(RFA)is one of the effective therapeutic modalities in patients with hepatocellular carcinoma(HCC).However,there is no proper method to evaluate the HCC response to RFA.This study aimed to establish and validate a clinical prediction model based on dual-energy com-puted tomography(DECT)quantitative-imaging parameters,clinical variables,and CT texture parameters.Methods:We enrolled 63 patients with small HCC.Two to four weeks after RFA,we performed DECT scanning to obtain DECT-quantitative parameters and to record the patients’clinical baseline variables.DECT images were manually segmented,and 56 CT texture features were extracted.We used LASSO al-gorithm for feature selection and data dimensionality reduction;logistic regression analysis was used to build a clinical model with clinical variables and DECT-quantitative parameters;we then added texture features to build a clinical-texture model based on clinical model.Results:A total of six optimal CT texture analysis(CTTA)features were selected,which were statis-tically different between patients with or without tumor progression(Ptumor progression,while the clinical-texture models showed that ALBI(OR=2.40,95%CI:1.19-5.68,P=0.024),λAP(40-100 keV)(OR=1.43,95%CI:1.10-2.07,P=0.019),and CTTA-score(OR=2.98,95%CI:1.68-6.66,P=0.001)were independent risk factors for tumor progression.The clinical model,clinical-texture model,and CTTA-score all performed well in predicting tumor progression within 12 months after RFA(AUC=0.917,0.962,and 0.906,respectively),and the C-indexes of the clinical and clinical-texture models were 0.917 and 0.957,respectively.Conclusions:DECT-quantitative parameters,CTTA,and clinical variables were help

关键词： Hepatocellular carcinoma Dual-energy Radiofrequency ablation tumor response Texture analysis

Prognostic value of serum uric acid and tumor response to induction chemotherapy in locally advanced nasopharyngeal carcinoma

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Prognostic value of serum uric acid and tumor response to in...

Evaluation of tumor response to cytokine-induced killer cells therapy in malignant solid tumors

2021年中国肿瘤标志物学术大会暨第十五届肿瘤标志物青...

作者： Xinyi Huang Qinyan Chen Lin Chen Yuanji Xu Zijie Wu Penggang Bai Chuanben Chen Department of Radiation Oncology Fujian Medical University Cancer Hospital Fujian Cancer Hospital

Background: To explore the combined predictive value of serum uric acid（SUA） and tumor response to induction chemotherapy（IC） in locally advanced nasopharyngeal carcinoma（LANPC） patients receiving IC followed by concurrent chemoradiation therapy（CCRT）.Methods: A total of 341 LANPC patients treated with IC + CCRT were enrolled in this retrospective study.Overall survival（OS）, progression-free survival（PFS）, locoregional relapse-free survival（LRFS）, and distant metastasis-free survival（DMFS） were compared by the Kaplan-Meier analysis and the logrank test, and multivariable survival analysis was carried out to investigate the independent prognostic factors.Results: Univariate analysis showed that a low SUA level and unsatisfactory tumor response to two cycles of IC both were negative predictors for OS, PFS, and DMFS in patients with LANPC. multivariable analysis demonstrated that the SUA level after two cycles of IC was an independent prognostic factor for OS（P=0.012） but of borderline significance for PFS and DMFS（P=0.055 and P=0.067,respectively）. Furthermore, tumor response to IC was of independent significance for predicting OS,PFS, and DMFS, respectively. Finally, LANPC patients with satisfactory tumor response and a high SUA level after two cycles of IC had a better OS, PFS, and DMFS than those with unsatisfactory tumor response and a low SUA level.Conclusion: The SUA level and the tumor response to two cycles of IC had predictive value for LANPC patients treated with IC plus CCRT. However, more aggressive therapeutic strategies are recommended for those with a low SUA level and unsatisfactory tumor response to two cycles of IC.

关键词： Nasopharyngeal carcinoma Serum uric acid tumor response Prognosis

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Evaluation of tumor response to cytokine-induced killer cell...

tumor irradiation may facilitate the detection of tumor-specific mutations in plasma

第九届全国免疫学学术大会

作者： Xiao-Dong Li Binfeng Lu Changping Wu Jingting Jiang Department of tumor Biological Treatment The Third Affiliated Hospital of Soochow University Department of Immunology University of Pittsburgh School of Medicine

CIK cells therapy has been evaluated as an adoptive cell immunotherapy for cancer patients,but there still have not been any standardized systems for evaluating the antitumor efficacy yet.The WHO and RECIST criteria have already been established for a few years but not sufficient to fully characterize the activity of immunotherapy.Based on these two criteria,the irRC was proposed for evaluating the efficacy of immunotherapy.A variety of bioassays for immune monitoring including the specific and non-specific methods,have been established.We recommend detect levels of various immunocytes,immune molecules and soluble molecules to find the correlations among them and clinicopathological characteristics to establish criteria for immunological classification.We also recommend a paradigm shift for the oncologists in the evaluation of immune therapies to ensure assessment of activity based on clinically relevant criteria and time points.

关键词： CIK cells therapy tumor response evaluation system

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World Journal of Clinical Oncology 2021年第12期12卷 1215-1226页

作者： Ekaterina Kuligina Fedor Moiseyenko Sergey Belukhin Ekaterina Stepanova Maria Zakharova Vera Chernobrivtseva Ikram Aliev Tatiana Sharabura Vladimir Moiseyenko Svetlana Aleksakhina Tatiana Laidus Aleksandr Martianov Maksim Kholmatov Aldon Whitehead Grigoriy Yanus Evgeny Imyanitov Department of tumor Biology N.N.Petrov Institute of OncologySt.-Petersburg 197758Russia Department of Medical Genetics St.-Petersburg Pediatric Medical UniversitySt.-Petersburg 194100Russia Department of Therapy City Cancer CenterSt.-Petersburg 197758Russia Department of Surgery City Cancer CenterSt.-Petersburg 197758Russia Department of Radiology City Cancer CenterSt.-Petersburg 197758Russia Internal Medicine Residency Program The University of Illinois College of MedicineChicagoIL 60612United States Department of Oncology I.I.Mechnikov Northwestern Medical UniversitySt.-Petersburg 191015Russia

BACKGROUND The mutation-based analysis of circulating tumor DNA(ctDNA)is a promising diagnostic tool for clinical oncology.However,it has low success rate because many cancer patients do not have detectable ctDNA in the bloodstream.AIM To evaluate whether preoperative tumor irradiation results in a transient increase of plasma ctDNA concentration due to the induction of apoptosis in radiationexposed cells.METHODS This study focused on patients with locally advanced rectal cancer,because preoperative tumor irradiation is a part of their standard treatment plan.Nine subjects,whose tumors contained KRAS,NRAS or BRAF mutations,donated serial blood samples 1 h prior to the first fraction of irradiation(at baseline),immediately after the first fraction(time 0),and 1,3,6,12,24,36,48,72 and 96 h after the first fraction.The amount of mutated gene copies was measured by droplet digital PCR.RESULTS Five out of nine patients were mutation-negative by ctDNA test at baseline;two of these subjects demonstrated an emergence of the mutated DNA copies in the bloodstream within the follow-up period.There were 4 patients,who had detectable ctDNA in the plasma at the start of the experiment;three of them showed an evident treatment-induced increase of the content of mutated RAS/RAF alleles.CONCLUSION Local tumor irradiation may facilitate the detection of tumor-specific DNA in the bloodstream.These data justify further assessment of the clinical feasibility of irradiation-assisted liquid biopsy.

关键词： Liquid biopsy Rectal cancer KRAS BRAF Mutations tumor response Radiotherapy

Role of imaging in evaluating the response after neoadjuvant treatment for pancreatic ductal adenocarcinoma

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World Journal of Gastroenterology 2021年第22期27卷 3037-3049页

作者： Yun Zhang Zi-Xing Huang Bin Song Department of Radiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

Pancreatic ductal adenocarcinoma(PDAC)is a highly aggressive malignancy.Despite the development of multimodality treatments,including surgical resection,radiotherapy,and chemotherapy,the long-term prognosis of patients with PDAC remains poor.Recently,the introduction of neoadjuvant treatment(NAT)has made more patients amenable to surgery,increasing the possibility of R0 resection,treatment of occult micro-metastasis,and prolongation of overall survival.Imaging plays a vital role in tumor response evaluation after NAT.However,conventional imaging modalities such as multidetector computed tomography have limited roles in the assessment of tumor resectability after NAT for PDAC because of the similar appearance of tissue fibrosis and tumor infiltration.Perfusion computed tomography,using blood perfusion as a biomarker,provides added value in predicting the histopathologic response of PDAC to NAT by reflecting the changes in tumor matrix and fibrosis content.Other imaging technologies,including diffusion-weighted imaging of magnetic resonance imaging and positron emission tomography,can reveal the tumor response by monitoring the structural changes in tumor cells and functional metabolic changes in tumors after NAT.In addition,with the renewed interest in data acquisition and analysis,texture analysis and radiomics have shown potential for the early evaluation of the response to NAT,thus improving patient stratification to achieve accurate and intensive treatment.In this review,we briefly introduce the application and value of NAT in resectable and unresectable PDAC.We also summarize the role of imaging in evaluating the response to NAT for PDAC,as well as the advantages,limitations,and future development directions of current imaging techniques.

关键词： Pancreatic ductal adenocarcinoma Neoadjuvant treatment Imaging Resectability tumor response Prognosis