磁共振弥散加权成像对宫颈癌新辅助化疗后无进展生存期的预测价值

doi:10.11904/j.issn.1002-3070.2014.06.008

Abstract

Abstract:

Objective To evaluate the predictive value of diffusion weighted imaging(DWI)for progression free survival(PFS)in patients with cervix cancer after neoadjuvant chemotherapy(NACT).Methods Thirty two consecutive patients with pathologically confirmed cervical cancer underwent MRI including DWI before and after NACT.Pathologic results and MR images were reviewed.Univariate analysis was applied by Kaplan-Meier method.The Cox proportional hazard model was used to evaluate prognostic variables for multivariate analysis.Receiver operating characteristic(ROC)curves were used to find optimal cutoff values of independent prognostic factors for disease progression.Results Of 32 patients,10 had disease progression during follow-up period.In univariate analysis,FIGO stage,tumor size,the depth of tumor invasion,lymph node metastasis and ADC changes between before and after neoadjuvant chemotherapy(ΔADC)were significantly associated with the disease progression.In multivariate analysis,FIGO stage and ΔADC were the independent prognostic factors for PFS.Optimal cutoff values that determined by ROC curves analyses were FIGO stage Ⅱ and ΔADC 0.31.Area under the ROC curve(AUC)of FIGO stage and ΔADC were 0.841(sensitivity 90.0%,specificity 68.2%)and 0.864(sensitivity 80.0%,specificity 81.8%),respectively.Conclusion In patients with cervix cancer after NACT,FIGO stage andΔADC are significant predictive values for PFS.

Key words: Diffusion weighted imaging(DWI), Apparent diffusion coefficient, Cervical cancer, Neoadjuvant chemotherapy, Progression free survival

CLC Number:

R737.33

ZHU Hong,ZHU Li,HAN Shiyu,FANG Fang,YU Yang. The predictive value of DWI for progression free survival in patients with cervix cancer after neoadjuvant chemotherapy[J]. PRACTICAL ONCOLOGY JOURNAL, 2014, 28(6): 519-523.

References

1 Hiroshi M,Hiroki K,Tatsuro F,et al.Predictive value of diffusion-weighted magnetic resonance imaging during chemoradiotherapy for uterine cervical cancer[J].J Obstet Gynaecol Res,2014,40(4):1098-1104.
2 刘云聪,张瑜,陈燕平.新辅助化疗治疗35例中晚期宫颈癌患者临床疗效观察[J].现代诊断与治疗,2014,25(8):1890-1891.
3 Satoshi Y,RyuichiroN,Nobuo Y,et al.Phase II study of neoadjuvant chemotherapy with irinotecan hydrochloride and nedaplatin followed by radical hysterectomy for bulky stage Ib2 to IIb,cervical squamous cell carcinoma:Japanese gynecologic oncology group study(JGOG 1065)[J].Oncology Reports,2012,28(2):487-493.
4 孙晓梅,温宏武,廖秦平.新辅助化疗在宫颈癌治疗中的应用及疗效观察[J].中国妇产科临床杂志,2008,9(3):166-169.
5 姜蕾,周意明,陈敏.功能磁共振成像早期评估乳腺癌新辅助化疗疗效的临床研究[J].中华乳腺病杂志(电子版),2011,5(3):272-282.
6 曾江正,雷俊华,洪涛,等.晚期结直肠癌组织表观弥散系数与化疗疗效的关系[J].临床肿瘤学杂志,2013,18(3):216-219.
7 Gbolahan S,Vanessa H,Scott S,et al.Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation[J].Eur Radiol,2012,22(11):2319-2327.
8 Hyun SK,Chan KK,Byung KP,et al.Evaluation of therapeutic response to concurrent chemoradiotherapy in patients with cervical cancer using diffusion-weighted MR imaging[J].J Magn Reson Imaging,2013,37(1):187-193.
9 李金枝,杨兴升,赵俊红.宫颈癌新辅助化疗的Meta分析[J].国际妇产科学杂志,2008,35(5):379-383.
10 Binbin T,Lingying W,Manni H.Outcomes and prognostic factors of advanced squamous cervical cancer after concurrent chemoradiotherapy[J].Zhonghua Fu Chan Ke Za Zhi,2014,49(5):348-354.
11 Tamar P,Gal I,Gilad B,et al.Effect of treatment delay on survival in patients with cervical cancer a historical cohort study[J].Int J Gynecol Cancer,2014,24:1326-1332.
12 Sardain H,Lavoué V,Laviolle B,et al.Prognostic factors for curative pelvic exenterations in patients with recurrent uterine cervical or vaginal cancer[J].Int J Gynecol Cancer,2014,24(9):1679-1685.
13 Sala P,Marchiolè P,Cittadini G,et al.Is magnetic resonance imaging useful in early evaluation of women on neoadjuvant chemotherapy for locally advanced cervical cancer?[J].Eur J Gynaecol Oncol,2012,33(1):31-36.
14 莫蕾,江新青,陈阿梅.DWI对宫颈癌的诊断及与肿瘤细胞密度相关性的初步研究[J].中国CT和MRI杂志,2011,9(3):49-52.
15 刘颖,白人驹,孙浩然.扩散加权成像预测、监测宫颈癌放化疗效果[J].中国医学影像技术,2009,25(7):1269-1272.
16 Jung JP,Chan KK,Sung YP,et al.Assessment of early response to concurrent chemoradiotherapy in cervical cancer:value of diffusion-weighted and dynamic contrast-enhanced MR imaging[J].Magnetic Resonance Imaging,2014,32(8):993-1000.

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The predictive value of DWI for progression free survival in patients with cervix cancer after neoadjuvant chemotherapy

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