■对于局部晚期宫颈癌(LACC),即使在国际妇产科联合会(FIGO)具有相同阶段分类的患者中,对放射疗法(RT)的治疗反应也可能存在显着差异。这项研究调查了ADC指标在预测接受RT治疗的LACC患者治疗结束时的价值。
■80例经病理证实的宫颈鳞状细胞癌(SCC)患者被纳入研究。对所有参与者进行腹部或盆腔MRI扫描至少三次:在RT之前,RT开始后3周和RT结束后约2个月.LACC的计算表观扩散系数(ADC)值包括:pre-ADC,临时ADC,ΔADC和Δ%ADC。根据实体瘤的反应评估标准(RECIST)1.1,计算受试者并随后将其分为良好反应者组(完全反应)和不良反应者组(进行性疾病,稳定的疾病或部分反应)。
■与反应良好的人相比,低反应组的受试者显示出显著较低的临时ADC值,ΔADC,和Δ%ADC(均P<0.05)。区分好的和差的反应者,临时ADC的最佳截止值,ΔADC,Δ%ADC确定为1.067×10-3mm2/sec,0.209×10-3mm2/sec,和30.74%使用ROC曲线,相应的灵敏度为83.78%,86.49%,75.68%,和88.37%的特异性,86.49%,75.68%,分别。多因素logistic回归显示,基线肿瘤直径和中期ADC是治疗反应的重要预后因素,基线肿瘤直径的比值比(OR)为0.105(95%置信区间[95%CI]0.018-0.616),中期ADC的比值比为42.896(95%CI8.205-224.262)。
■临时ADC值和基线肿瘤直径成为预测LACC患者对RT反应的可能指示因素。
UNASSIGNED: For locally advanced cervical cancer (LACC), treatment response to radiotherapy (RT) can vary significantly even among those with the same stage classification of International Federation of Gynecology and Obstetrics (FIGO). This study investigated the value of ADC metric for forecasting end-of-treatment outcomes in LACC patients referred for RT.
UNASSIGNED: Eighty patients with pathologically confirmed cervical squamous cell carcinoma with (SCC) were included in the research. Abdominal or pelvic MRI scans were conducted at least three times for all participants: before RT, three weeks after beginning of RT and approximately two months after RT was finalized. Calculated apparent diffusion coefficient (ADC) values of the LACC include: pre-ADC, interim-ADC, ΔADC and Δ%ADC. Based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, subjects were calculated and subsequently categorized into good responders group (complete response) and poor responders group (progressive disease, stable disease or partial response).
UNASSIGNED: Compared to good-responders, subjects of poor-responder group showed significantly lower values of interim-ADC, ΔADC, and Δ%ADC (all P < 0.05). To distinguish between good and poor responders, the optimal cutoff values of interim-ADC, ΔADC, and Δ%ADC were determined to be 1.067 × 10-3 mm2/sec, 0.209 × 10-3 mm2/sec, and 30.74 % using the ROC curve, with corresponding sensitivities of 83.78 %, 86.49 %, 75.68 %, and specificities of 88.37 %, 86.49 %, 75.68 %, respectively. Multivariate logistic regression revealed that the baseline tumor diameter and interim-ADC were significant prognostic factors for treatment response with an odds ratio (OR) of 0.105 (95 % confidence interval [95 % CI] 0.018-0.616) for baseline tumor diameter and 42.896 (95 % CI 8.205-224.262) for interim-ADC.
UNASSIGNED: The interim-ADC value and baseline tumor diameter surfaced as possible indicative factors for predicting the response to RT in patients with LACC.