摘要
目的:同时采用RECIST标准和Choi标准,探讨和比较多层螺旋CT用于分子靶向治疗药物甲磺酸伊马替尼(格列卫)治疗胃肠间质瘤(GIST)疗效评价的临床价值。方法:2004年2月～2008年2月的4年间,本院收治和应用格列卫治疗的GIST患者62例,定期进行临床和多层螺旋CT检查,严密随访,动态观察病灶的大小、形态及密度变化,分别根据RE-CIST标准和Choi标准评价疗效,进行分析比较。结果:62例GIST患者中,格列卫治疗前、后按照RECIST CT标准评价,获得PR37例(59.7%),SD18例(29%),PD7例(11.3%);而依据Choi标准,CT的Hu值明显下降的有11例,略微下降的19例,基本一致的28例,增高的有4例。其中,有5例肝脏多发转移GIST,格列卫治疗半年后,原肝内多发低密度的转移灶发生囊性变。结论:多层螺旋CT扫描是诊断和随访GIST的最常用和有价值的影像学手段。按照Choi标准,通过CT同时观察Hu值和大小变化来监测和评价格列卫的疗效,更加客观和全面,对于指导临床治疗具有重要意义。
Objective： To study the response value of muhi-slice spiral CT imaging in the gastrointestinal stromal tumor （GIST） treated with imatinib mesylate （gleevec）. Methods：A total of 62 GIST eases confirmed after operation and by pathological examination were retrospectively analyzed. All the cases treated with molecular targeted therapy drug gleevec were followed up by CT scanning regularly to observe changes in the size, shape and density of lesions. The therapeutic effects were evaluated according to RE- CIST and Choi criteria. Results ： Among total 62 GIST eases evaluated by CT scan according to RECIST criteria, there were none of CR case, but 37 cases （59. 7% ） PR, 18 cases （29%） SD and 7 cases （11.3%） PD. CT values contrasted before and after treatment according to Choi standard showed the density decreased magnificently in 11 eases, decreased slightly in 19 cases, almost the same in 28 cases and the density increased in 4 cases. In 5 GIST cases concomitant liver muhi-metastasis, lower density of metastasis lesions converted to approximately cyst density after treating with gleevee for half a year. Conclusion ： Multi-slice CT imaging is the most useful and evaluable method for diagnosis of GIST. It is one of the most important and direct method to evaluate response of GIST treated with gleevec, which has significant meaning in guiding clinical therapy.
出处
《临床肿瘤学杂志》
CAS
2009年第6期524-529,共6页
Chinese Clinical Oncology
