非小细胞肺癌患者EGFR-TKI靶向治疗前后肿瘤体积变化规律及其临床价值

doi:10.13481/j.1671-587x.20160229

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (02): 345-350.doi: 10.13481/j.1671-587x.20160229

非小细胞肺癌患者EGFR-TKI靶向治疗前后肿瘤体积变化规律及其临床价值

邹喜, 陈金梅, 洪金省, 郭飞宝, 蓝林臻, 张纬建

福建医科大学附属第一医院放疗科放射生物福建省高等学校重点实验室福建省肿瘤个体化主动免疫治疗重点实验室, 福建福州 350005

收稿日期:2015-07-15 发布日期:2016-03-31
通讯作者: 张纬建,副教授,主任医师,硕士研究生导师(Tel:0591-87982181,E-mail:zwj9090@126.com) E-mail:zwj9090@126.com
作者简介:邹喜(1985-),男,湖南省邵阳市人,医师,医学硕士,主要从事肿瘤放射治疗方面的研究。
基金资助:
福建省卫生厅青年科研基金资助课题(2013-01-30);福建省卫生厅医学创新基金资助课题(2012-CX-20)

Tumor volume recession pattern of patients with non-small cell lung cancer before and after EGFR-TKI targeting treatment and its clinical value

ZOU Xi, CHEN Jinmei, HONG Jinsheng, GUO Feibao, LAN Linzhen, ZHANG Weijian

Department of Radiotherapy, First Affiliated Hospital, Fujian Medical University, Key Laboratory of Radiation Biology, Fujian Province Key Laboratory of Tumor Individualized Active Immunotherapy, Fuzhou 350005, China

Received:2015-07-15 Published:2016-03-31

摘要/Abstract

摘要：

目的: 探讨非小细胞肺癌(NSCLC)患者表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)靶向治疗前后肿瘤体积的变化规律,阐明其临床价值。方法: 回顾性分析EGFR-TKI靶向治疗的39例NSCLC患者资料,使用TPS自带体积测量软件及ImageJ图像处理软件分别测量靶向治疗前、治疗后每个月的肿瘤体积,采用配对样本比较的Wilcoxon符号秩检验配对分析EGFR-TKI靶向治疗前、治疗后肿瘤绝对体积和相对体积变化情况。结果: EGFR-TKI靶向治疗前和治疗后第1个月患者肿瘤绝对体积(mm³)分别为14822.11(7524.73,54999.41)和7954.42(3499.73,29396.83),差异有统计学意义(Z=-3.257,P=0.001);治疗者第1个月和第2个月的肿瘤绝对体积分别为8358.47(4394.36,24430.05)和7028.76(3634.98,21056.71),差异也有统计学意义(Z=-2.213,P=0.027)。若将治疗前肿瘤体积设为1,则治疗后第1个月肿瘤相对体积为0.6126(0.3138,0.8537),差异有统计学意义(Z=-3.855,P<0.001);第1个月和第2个月肿瘤相对体积分别为0.6084(0.3643,1.0443)和0.4230(0.2488,0.8777),差异也有统计学意义(Z=-2.173,P=0.030)。其余相邻月份间肿瘤绝对体积和相对体积比较差异无统计学意义(P>0.05)。肿瘤相对体积在治疗后3个月开始出现平台期,在治疗后第7~9个月达到最小值。结论: NSCLC患者靶向治疗后第1和2个月原发灶肿瘤体积下降较为明显,在治疗后第3~9个月介入放疗可能较适合。

关键词: 癌, 非小细胞肺, 肿瘤体积, 表皮生长因子受体酪氨酸激酶抑制剂, 放射治疗

Abstract:

Objective: To explore the regular variation pattern of tumor volumes of the patients with non-small cell lung cancer(NSCLC)before and after targeting treatment of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI), and to clarify its clinical value.Methods: The materials of 39 NSCLC patients with EGFR-TKI targeting treatment were retrospectively analyzed. The tumor volumes were detected by volume measurement software of TPS and Image J image processing software, then the absolute and relative tumor volume changes of the NSCLC patients before and after targeting treatment were analyzed by paired sample comparison symbol Wilcoxon rank test. Results: The absolute tumor volumes(mm³) of the patients with NSCLC before and 1 month after targeting treatment were 14822.11(7524.73, 54999.41)and 7954.42(3499.73, 29396.83), respectively, and there was statistically significant difference(Z=-3.257, P=0.001);the absolute tumor volumes of the patients with NSCLC 1 and 2 months after targeting treatment were 8 358.47(4394.36, 24 430.05)and 7028.76(3634.98, 21056.71), respectively, and there also was statisticaliy significant difference(Z=-2.213, P=0.027).When the original tumor volume before targeting treatment was regarded as 1, the relative tumor volume of 1 month after targeting theatment was 0.612 6(0.313 8, 0.853 7), and there was significant difference(Z=-3.855, P<0.001);the relative tumor volumes of 1 month and 2 months after targeting treatment were 0.6084(0.3643, 1.0443) and 0.423 0(0.248 8, 0.877 7), respectively, and there also was statistically significant differernce(Z=-2.173, P=0.030);but the differences between other consecutive months(from 3 months to 6 months) had no statistically significant differences(P>0.05);the changes of tumor relative volume presented platform stage after 3 months.The tumor relative volumes of 7-9 months after EGFR-TKI treatment reached the bottom. Conclusion: The average primary tumor volume of the NSCLC patients is obviously reduced 1 and 2 months after TKI targeting treatment.It may be optimal to carry out radiotherapy in 3-9 months after EGFR-TKI targeting treatment.

Key words: carcinoma,non-small-cell lung, tumor volume, epidermal growth factor receptor tyrosine kinase inhibitors, radiotherapy

中图分类号:

R734.2

邹喜, 陈金梅, 洪金省, 郭飞宝, 蓝林臻, 张纬建. 非小细胞肺癌患者EGFR-TKI靶向治疗前后肿瘤体积变化规律及其临床价值[J]. 吉林大学学报(医学版), 2016, 42(02): 345-350.

ZOU Xi, CHEN Jinmei, HONG Jinsheng, GUO Feibao, LAN Linzhen, ZHANG Weijian. Tumor volume recession pattern of patients with non-small cell lung cancer before and after EGFR-TKI targeting treatment and its clinical value[J]. Journal of Jilin University Medicine Edition, 2016, 42(02): 345-350.

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非小细胞肺癌患者EGFR-TKI靶向治疗前后肿瘤体积变化规律及其临床价值

Tumor volume recession pattern of patients with non-small cell lung cancer before and after EGFR-TKI targeting treatment and its clinical value

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