Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Comparison of CT Volumetry and RECIST to Predict the Treatment Response and Overall Survival in Gastric Cancer Liver Metastases

위암 간전이 환자의 반응평가와 생존율 예측을 위한 종양 부피 측정과 RECIST 기준의 비교 연구

  • Sung Hyun Yu (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Seung Joon Choi (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • HeeYeon Noh (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • In seon Lee (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • So Hyun Park (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Se Jong Kim (Gil Medical Center, Gachon University College of Medicine)
  • 유성현 (가천대학교 의과대학 길병원 영상의학과) ;
  • 최승준 (가천대학교 의과대학 길병원 영상의학과) ;
  • 노희연 (가천대학교 의과대학 길병원 영상의학과) ;
  • 이인선 (가천대학교 의과대학 길병원 영상의학과) ;
  • 박소현 (가천대학교 의과대학 길병원 영상의학과) ;
  • 김세종 (가천대학교 의과대학 길병원)
  • Received : 2020.04.28
  • Accepted : 2020.09.08
  • Published : 2021.07.01
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Abstract

Purpose The aim of this study was to compare the diameter and volume of liver metastases on CT images in relation to overall survival and tumor response in patients with gastric cancer liver metastases (GCLM) treated with chemotherapy. Materials and Methods We recruited 43 patients with GCLM who underwent chemotherapy as a first-line treatment. We performed a three-dimensional quantification of the metastases for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors (RECIST) was performed and compared to volumetric measurements. Overall survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios following univariate analyses. Results When patients were classified as responders or non-responders based on volumetric criteria, the median overall survival was 23.6 months [95% confidence interval (CI), 8.63-38.57] and 7.6 months (95% CI, 3.78-11.42), respectively (p = 0.039). The volumetric analysis and RECIST of the non-progressing and progressing groups showed similar results based on the Kaplan-Meier method (p = 0.006) and the Cox proportional hazard model (p = 0.008). Conclusion Volumetric assessment of liver metastases could be an alternative predictor of overall survival for patients with GCLM treated with chemotherapy.

목적 항암 치료를 진행하는 위암 간전이 환자에서 종양의 길이를 이용한 반응 평가와 비교하여 종양의 부피를 이용한 반응 평가가 환자의 생존율을 더 잘 예측할 수 있는지 알아보는 연구이다. 대상과 방법 항암 치료를 진행하는 위암 간전이 환자 43명을 연구에 포함하였다. 간전이 종양의 부피를 정량적으로 계산한 기준과 Response Evaluation Criteria in Solid Tumors 기준을 비교하였다. 카플란-마이어, 콕스비례위험 모형을 사용하여 일변량분석과 다변량분석을 통해 환자 생존율 및 연관된 인자를 알아보았다. 결과 저자들은 간전이 종양의 부피를 정량적으로 계산한 기준을 이용했을 때, 질환 반응군(23.6개월; 95% 신뢰구간, 8.63~38.57)과 질환 비반응군(7.6개월; 95% 신뢰구간, 3.78~11.42)간 생존율에 통계학적 유의한 차이를 확인하였다(p = 0.039). 질환 안정군과 질환 진행군을 부피를 이용한 반응 평가와 길이를 이용한 반응 평가로 구분할 경우 양군은 생존기간과 위험비에서 의미 있는 차이를 보였으나 두 반응 평가 방법 간 차이는 없었다(카플란-마이어 모형: p = 0.006; 콕스비례위험 모형: 위험비, 2.437, p = 0.008). 결론 항암 치료를 진행하는 위암 간전이 환자들에서 간전이의 부피 반응 평가는 환자들의 생존율을 예측하는 데 도움을 줄 수 있다.

Keywords

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