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Assessment of clinical and radiological response to sorafenib in hepatocellular carcinoma patients

World Journal of Hepatology 2015年第1期7卷 33-39页

作者： Rodolfo Sacco Valeria Mismas Antonio Romano Marco Bertini Michele Bertoni Graziana Federici Salvatore Metrangolo Giuseppe Parisi emanuele Tumino Giampaolo Bresci Luca Giacomelli Sara Marceglia Irene Bargellini dipartimento di gastroenterologia-uo gastroenterologia e malattie del ricambio Azienda Ospedaliero Universitaria Pisana56124 PisaItaly dipartimento di elettronica Informazione e BioingegneriaPolitecnico di Milano20100 MilanItaly dipartimento di Radiologia-Azienda Ospedaliero Universitaria Pisana 56124 PisaItaly

Sorafenib is an effective anti-angiogenic treatment forhepatocellular carcinoma(HCC). The assessment of tumor progression in patients treated with sorafenib is crucial to help identify potentially-resistant patients,avoiding unnecessary toxicities. Traditional methods to assess tumor progression are based on variations in tumor size and provide unreliable results in patients treated with sorafenib. New methods to assess tumor progression such as the modified Response evaluation Criteria in Solid Tumors or european Association for the Study of Liver criteria are based on imaging to measure the vascularization and tumor volume(viable or necrotic). These however fail especially when the tumor response results in irregular development of necrotic tissue. Newer assessment techniques focus on the evaluation of tumor volume,density or perfusion. Perfusion computed tomography and Dynamic Contrastenhanced-UltraS ound can measure the vascularization of HCC lesions and help predict tumor response to antiangiogenic therapies. Mean Transit Time is a possible predictive biomarker to measure tumor response. Volumetric techniques are reliable,reproducible and time-efficient and can help measure minimal changes in viable tumor or necrotic tissue,allowing the prompt identification of non-responders. Volume ratio may be a reproducible biomarker for tumor response. Larger trials are needed to confirm the use of these techniques in the prediction of response to sorafenib.

关键词： Hepatocellular carcinoma Sorafenib Responseevaluation Criteria in Solid Tumors Perfusioncomputed tomography Dynamic Contrast-enhanced-UltraSound Volumetric assessment

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