Metastatic Renal Carcinoma: Evaluation of Antiangiogenic Therapy with Dynamic Contrast-enhanced CT

被引：103

作者：

Fournier, Laure S. ^{[1
,3
,4
]}

Oudard, Stephane ^{[2
,3
,4
]}

Thiam, Rokhaya ^{[3
,5
]}

Trinquart, Ludovic ^{[5
]}

Banu, Eugeniu ^{[2
]}

Medioni, Jacques ^{[2
]}

Balvay, Daniel ^{[3
,4
]}

Chatellier, Gilles ^{[5
]}

Frija, Guy ^{[1
,3
]}

Cuenod, Charles A. ^{[1
,3
,4
]}

机构：

[1] Hop Europeen Georges Pompidou, AP HP, Dept Radiol, F-75015 Paris, France

[2] Hop Europeen Georges Pompidou, AP HP, Dept Oncol, F-75015 Paris, France

[3] INSERM, Paris Cardiovasc Res Ctr, U970, Paris, France

[4] Univ Paris 05, UMR S970, Paris, France

[5] Univ Paris 05, Hop Europeen Georges Pompidou, AP HP, Epidemiol & Clin Res Unit,INSERM,CIE 4, Paris, France

来源：

RADIOLOGY | 2010年 / 256卷 / 02期

关键词：

TISSUE HOMOGENEITY MODEL; TUMOR PERFUSION; CELL CARCINOMA; ADIABATIC APPROXIMATION; QUANTITATIVE ASSESSMENT; MULTIDETECTOR CT; WATER EXCHANGE; SOLID TUMORS; ANGIOGENESIS; CANCER;

D O I：

10.1148/radiol.10091362

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To determine whether tumor perfusion parameters assessed by using dynamic contrast material-enhanced computed tomography (CT) could help predict and detect response in patients receiving antiangiogenic therapy for metastatic renal cell carcinoma. Materials and Methods: Institutional ethics committee approval and informed consent were obtained. In two phase-III trials involving 51 patients with metastatic renal cell carcinoma (38 men, 13 women; age range, 30-80 years) receiving antiangiogenic drugs (sorafenib [n = 10], sunitinib [n = 22]), a placebo (n = 12), or interferon alfa (n = 7), serial dynamic contrast-enhanced CT was performed, during 90 seconds before and after injection of 80 mL of iobitridol. Perfusion parameters of a target metastatic tumor (tumor blood flow [TBF], tumor blood volume [TBV], mean transit time, and vascular permeability-surface area product) were calculated. Values before and after treatment were compared by using a Wilcoxon signed rank test, and relative changes in groups were compared by using the Wilcoxon rank sum test. Results were compared with Response Evaluation Criteria in Solid Tumors response and with progression-free and overall survival by using Kaplan-Meier curves. Results: Among patients receiving antiangiogenic drugs, baseline perfusion parameters were higher in responders than in stable patients (TBF = 245.3 vs 119.5 mL/min/100 mL, P = .04;TBV = 15.5 vs 8.2 mL/100 mL, P = .02) but were not significantly predictive of survival. After the first cycle of treatment, there was a significant decrease in TBF (162.5 vs 76.7 mL/min/100 mL, P = .0002) and TBV (9.1 vs 3.9 mL/100 mL, P < .0001) in patients receiving antiangiogenic treatment. Conclusion: Renal carcinoma perfusion parameters determined with dynamic contrast-enhanced CT can help predict biologic response to antiangiogenic drugs before beginning therapy and help detect an effect after a single cycle of treatment. (C) RSNA, 2010

引用

页码：511 / 518

页数：8

共 25 条

[11] Normalizing tumor vasculature with anti-angiogenic therapy: A new paradigm for combination therapy [J].

Jain, RK .

NATURE MEDICINE, 2001, 7 (09) :987-989

[12] Functional CT for quantifying tumor perfusion in antiangiogenic therapy in a rat model [J].

Kan, ZX ;

Phongkitkarun, S ;

Kobayashi, S ;

Tang, Y ;

Ellis, LM ;

Lee, TY ;

Charnsangavej, C .

RADIOLOGY, 2005, 237 (01) :151-158

[13] To predict progression-free survival and overall survival in metastatic renal cancer treated with sorafenib:: Pilot study using dynamic contrast-enhanced Doppler ultrasound [J].

Lamuraglia, Michele ;

Escudier, Bernard ;

Chami, Linda ;

Schwartz, Brian ;

Leclere, Jerome ;

Roche, Alain ;

Lassau, Nathalie .

EUROPEAN JOURNAL OF CANCER, 2006, 42 (15) :2472-2479

[14] Gastrointestinal stromal tumors treated with imatinib:: Monitoring response with contrast-enhanced sonography [J].

Lassau, Nathalie ;

Lamuraglia, Michele ;

Chami, Linda ;

Leclere, Jerome ;

Bonvalot, Sylvie ;

Terrier, Philippe ;

Roche, Alain ;

Le Cesne, Axel .

AMERICAN JOURNAL OF ROENTGENOLOGY, 2006, 187 (05) :1267-1273

[15]

Lee TY, 2003, Q J NUCL MED, V47, P171

[16] A CONCORDANCE CORRELATION-COEFFICIENT TO EVALUATE REPRODUCIBILITY [J].

LIN, LI .

BIOMETRICS, 1989, 45 (01) :255-268

[17] Sunitinib versus interferon alfa in metastatic renal-cell carcinoma [J].

Motzer, Robert J. ;

Hutson, Thomas E. ;

Tomczak, Piotr ;

Michaelson, M. Dror ;

Bukowski, Ronald M. ;

Rixe, Olivier ;

Oudard, Stephane ;

Negrier, Sylvie ;

Szczylik, Cezary ;

Kim, Sindy T. ;

Chen, Isan ;

Bycott, Paul W. ;

Baum, Charles M. ;

Figlin, Robert A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (02) :115-124

[18] Effect of nitric-oxide synthesis on tumour blood volume and vascular activity: a phase I study [J].

Ng, Quan-Sing ;

Goh, Vicky ;

Milner, Jessica ;

Stratford, Michael R. ;

Folkes, Lisa K. ;

Tozer, Gillian M. ;

Saunders, Michele I. ;

Hoskin, Peter J. .

LANCET ONCOLOGY, 2007, 8 (02) :111-118

[19] Treatment options in renal cell carcinoma: past, present and future [J].

Oudard, S. ;

George, D. ;

Medioni, J. ;

Motzer, R. .

ANNALS OF ONCOLOGY, 2007, 18 :25-31

[20] Targeted therapy for metastatic renal cell carcinoma [J].

Patel, PH ;

Chaganti, RSK ;

Motzer, RJ .

BRITISH JOURNAL OF CANCER, 2006, 94 (05) :614-619

← 1 2 3 →