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Abstract：
BACKGROUND: With the development of immune checkpoint inhibitors for the treatment of non-small cell lung cancer, the need for new functional imaging techniques and early response assessments has increased to account for new response patterns and the high cost of treatment. The present study was designed to assess the prognostic impact of dynamic contrast-enhanced computed tomography (DCE-CT) on survival outcomes in non-small cell lung cancer patients treated with immune checkpoint inhibitors.
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.
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.
摘要：
背景：随着用于治疗非小细胞肺癌的免疫检查点抑制剂的发展，对新的功能成像技术和早期反应评估的需求增加,以解释新的反应模式和高昂的治疗成本.本研究旨在评估动态对比增强计算机断层扫描（DCE-CT）对接受免疫检查点抑制剂治疗的非小细胞肺癌患者生存结果的预后影响。
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。
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。
