摘要
目的:探讨表观弥散系数(ADC)预测局部晚期鼻咽癌对含多西他赛新辅助化疗敏感性的价值。方法:集2013年3月到2015年7月的鼻咽癌Ⅲ期及Ⅳ期患者34例,分别在新辅助化疗前1周内及2周期新辅助化疗结束后1周进行磁共振扫描,采集不同时间点鼻咽癌原发灶的扩散加权图像(DWI)并分析获得的表观扩散系数(ADC),根据RECIST 1.1指南分别进行疗效分组(化疗高反应和化疗低反应组),采用独立样本t检验比较不同疗效组间不同时间点的ADC值,并应用Spearson等级相关性分析评价ADC值与肿瘤消退率的相关性。结果:新辅助化疗前,化疗高反应组的ADC值治疗前低于化疗低反应组[(1.32±0.25)×10^(-3)mm^2/s vs(1.61±0.24)×10^(-3)mm^2/s,P=0.001];化疗高反应组的ADC值治疗后为(2.12±0.26)×10^(-3)mm^2/s,而化疗低反应组的ADC值治疗后为(1.70±0.45)×10^(-3)mm^2/s、差异有统计学意义(P=0.032);化疗高反应组ADC值变化率(ΔADC)明显高于化疗低反应组[(63.1±35.6)%vs(14.3±36.9)%,P=0.021];ADC值治疗前与肿瘤消退率负相关(r=-0.451,P=0.007),ADC值治疗后和ADC值变化率(ΔADC)与肿瘤消退率正相关(r=0.667,P=0.005;r=0.550,P=0.027)。结论:核磁共振表观弥散系数对鼻咽癌新辅助化疗疗效可以进行早期评价,有助于早期进行治疗方案的调整。
Objective：To investigate the capability of apparent diffusion coefficient （ADC） for the prediction of neoadjuvant chemotherapy with docetaxel in locally advanced nasopharyngeal carcinoma. Methods ： 34 patients with stage Ⅲ - Ⅳ nasopharyngeal carcinoma were enrolled,from March 2013 to July 2015. Within 1 week before neoadju-vant chemotherapy and after 2 cycles neoadjuvant chemotherapy about 1 week MRI scan was performed. In different time points nasopharyngeal carcinoma primary diffusion weighted image （DWI） was collected, and the apparent diffu-sion coefficient （ ADC） was analysed. According to RECIST 1. 1 guide, patients were divided into chemotherapy high reaction group and chemotherapy low reaction group. Independent sample t - test was to compare different therapeutic groups of ADC values in different time points,and Spearson rank correlation analysis was to evaluate correlation be-tween ADC values and the rate of tumor regression. Results ： Before neoadjuvant chemotherapy,chemotherapy high re-action group ADC value was lower than low reaction group[ （1.32 ± 0. 25 ） × 10^3mm^2/ s vs （ 1.61 ± 0. 2 4 ） × 10^3mm^2/s,P =0. 001 ]. Chemotherapy high reaction group ADC value was （2. 12 ±0. 26） × 10^3mm^2/ s after treatment, and chemotherapy low reaction group ADC value after treatment was （ 1.70 ±0.45） x 10 3mm2/s ,w h ich was statisti-cally significant （P = 0. 032） . High chemotherapy response group of ADC value change rate （delta ADC） was signifi-cantly higher than low reaction chemotherapy group [（63. 1± 35.6）% vs （14.3 ±36.9）%,P = 0. 021]. ADC val-ue before the treatment was negatively related to the tumor regression rate （ r = - 0. 4 5 1 , P = 0 . 007 ） , and the ADC value after treatment and ADC value change rate （ delta ADC） were positively related to the tumor regression rate （ r - 0. 667 = 0. 005/r =0. 550 ,P =0. 0 2 7 ） . Conclusion： Nuclear magnetic resonance apparent diffusi
出处
《现代肿瘤医学》
CAS
2017年第10期1557-1560,共4页
Journal of Modern Oncology
关键词
鼻咽癌
新辅助化疗
表观弥散系数
疗效检测
nasopharyngeal carcinoma,neoadjuvant chemotherapy,apparent diffusion coefficient,effective detection
