| 张安度,韩晶,时高峰,韩春,王澜,王燕飞,张钧,田华,孔洁,张舰.MRI在预测食管癌放化疗治疗反应及疗效评估中的应用研究[J].中华放射医学与防护杂志,2016,36(11):822-826 |
| MRI在预测食管癌放化疗治疗反应及疗效评估中的应用研究 |
| The application of MRI in predicting therapeutic effect and prognosis of chemoradiotherapy for esophageal cancer |
| 投稿时间：2016-05-17 |
| DOI：10.3760/cma.j.issn.0254-5098.2016.11.005 |
| 中文关键词: 食管肿瘤 放化疗 弥散加权成像 表观弥散系数 |
| 英文关键词:Esophageal Neoplasms Chemoradiotherapy Diffusion-weighted imaging Apparent-diffusion coefficient |
| 基金项目: |
| 作者 | 单位 | E-mail | | 张安度 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 韩晶 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 时高峰 | 050011 石家庄, 河北医科大学第四医院放疗科 | gaofengs62@sina.com | | 韩春 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 王澜 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 王燕飞 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 张钧 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 田华 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 孔洁 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 张舰 | 050011 石家庄, 河北医科大学第四医院放疗科 | |
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| 中文摘要: |
| 目的 探讨磁共振弥散加权成像（MR-DWI）表观弥散系数（ADC值）在食管癌放化疗疗效判断及预后评估中的应用价值。方法 前瞻性入组2010年3月至2013年9月收治的食管癌患者100例，放疗前后均行MR-DWI检查。Kaplan-Meier并Logrank法计算生存率，Cox法多因素预后分析。结果 完全缓解（CR）组放疗前、放疗后ADC值均高于部分缓解（PR）组，差异有统计学意义（z=-3.010、-3.689，P<0.05）。肿瘤区域放疗前低ADC值组（≤1.60×10-3mm2/s）和高ADC值组（>1.60×10-3mm2/s）1、3、5年生存率分别为58.2%、21.9%、10.9%和73.3%、50.6%、39.2%（χ2=9.879，P<0.05）。肿瘤区域放疗后低ADC值组（≤2.50×10-3mm2/s）和放疗后高ADC值组（>2.50×10-3mm2/s）的1、3、5年生存率分别为52.2%、23.6%、14.2%和75.9%、44.1%、32.4%（χ2=5.455，P<0.05）。将放疗前低和高ADC值组按ΔADC大小分为4组，疗前高ADC值组ADC值上升较好，其生存情况最优，而疗前低ADC值组ADC值上升不佳，其预后最差，其他两组生存情况有交叉（χ2=13.096，P<0.05）。多因素Cox模型分析显示放疗前ADC分组为预后独立因素。结论 MR-DWI ADC值能有效预测食管癌治疗反应和预后。临床试验注册号 中国临床试验注册中心，ChiCTR-PNC-16009484 |
| 英文摘要: |
| Objective To explore magnetic resonance diffusion-weighted imaging (MR-DWI) apparent diffusion coefficient(ADC) value in predicting therapeutic effect and prognosis of chemoradiotherapy for esophageal cancer. Methods 100 cases of patients with esophageal carcinoma were enrolled from March 2010 to September 2013 prospectively, MR-DWI was performed before and after CRT. Kaplan-Meier and Logrank methods were used to calculate the overall survival, and Cox regression model was used for multivariate prognostic analysis. Results The ADC value of CR group was higher than that of the PR group both before and after radiotherapy(z=-3.010, -3.689, P<0.05). The 1, 3, 5-year survival rate of the low-ADC value group (≤1.60×10-3mm2/s) and the high-group (>1.60×10-3mm2/s) of tumor before radiotherapy were 58.2%, 21.9%, 10.9% and 73.3%, 50.6%, 39.2% respectively(χ2=9.879, P<0.05). The 1, 3, 5-year survival rate of the low-ADC value group (≤ 2.50×10-3mm2/s) and the high-group (>2.50×10-3mm2/s) after radiotherapy were 52.2%, 23.6%, 14.2% and 75.9%, 44.1%, 32.4% respectively(χ2=5.455, P<0.05). Both low-ADC value group and high-ADC value group before radiotherapy were divided into 4 groups according to ΔADC, the OS of the high-ADC value group before radiotherapy which had a higher ΔADC was the best, and the low-ADC value group before radiotherapy which had a lower ΔADC was the worst. The OS of the other two groups had an interaction (χ2=13.096, P<0.05). Multivariate analysis indicated that the pre-CRT ADC group was an independent prognostic factor for OS. Conclusions MR-DWI ADC value could predict therapeutic effect and prognosis in esophageal carcinoma.Trial registration Chinese clinical trial registry, ChiCTR-PNC-16009484 |
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