METHODS: Thirty-three patients with inoperable non-small-cell lung cancer treated with immune checkpoint inhibitors were prospectively enrolled for DCE-CT as part of their follow-up. A single target lesion at baseline and subsequent follow-up examinations were enclosed in the DCE-CT. Blood volume deconvolution (BVdecon), blood flow deconvolution (BFdecon), blood flow maximum slope (BFMax slope) and permeability were assessed using overall survival (OS) and progression-free survival (PFS) as endpoints in Kaplan Meier and Cox regression analyses.
RESULTS: High baseline Blood Volume (BVdecon) (> 12.97 ml × 100 g-1) was associated with a favorable OS (26.7 vs 7.9 months; p = 0.050) and PFS (14.6 vs 2.5 months; p = 0.050). At early follow-up on day seven a higher relative increase in BFdecon (> 24.50% for OS and > 12.04% for PFS) was associated with an unfavorable OS (8.7 months vs 23.1 months; p < 0.025) and PFS (2.5 vs 13.7 months; p < 0.018). The relative change in BFdecon (categorical) on day seven was a predictor of OS (HR 0.26, CI95: 0.06 to 0.93 p = 0.039) and PFS (HR 0.27, CI95: 0.09 to 0.85 p = 0.026).
CONCLUSIONS: DCE-CT-identified parameters may serve as potential prognostic biomarkers at baseline and during early treatment in patients with NSCLC treated with immune checkpoint inhibitor therapy.
方法:将使用免疫检查点抑制剂治疗的33例不能手术的非小细胞肺癌患者纳入DCE-CT作为随访的一部分。基线时的单个靶病变和随后的随访检查被封闭在DCE-CT中。血容量去卷积(BVdecon),血流量去卷积(BFdecon),在KaplanMeier和Cox回归分析中,使用总生存期(OS)和无进展生存期(PFS)作为终点来评估血流最大斜率(BFMax斜率)和通透性.
结果:高基线血容量(BVdecon)(>12.97ml×100g-1)与良好的OS(26.7vs7.9个月;p=0.050)和PFS(14.6vs2.5个月;p=0.050)相关。在第7天的早期随访中,BFdecon的相对升高(OS>24.50%,PFS>12.04%)与不良OS(8.7个月vs23.1个月;p<0.025)和PFS(2.5vs13.7个月;p<0.018)相关。第7天BFdecon(分类)的相对变化是OS(HR0.26,CI95:0.06至0.93p=0.039)和PFS(HR0.27,CI95:0.09至0.85p=0.026)的预测因子。
结论:在接受免疫检查点抑制剂治疗的NSCLC患者中,在基线和早期治疗期间,DCE-CT鉴定的参数可能作为潜在的预后生物标志物。