Evaluation value of neoadjuvant chemotherapy in patients with non-small cell lung cancer based on tumor volume measured by CT
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摘要:
目的 分析基于CT测量的肿瘤体积对非小细胞肺癌患者新辅助化疗疗效的评估价值。 方法 选取2019年5月~2020年5月在我院接受新辅助化疗的74例非小细胞肺癌患者,化疗后以病理结果为标准其分为有效组(n=51)和无效组(n=23),通过CT测量所有患者的肿瘤体积,并采用单因素和Logistic多因素回归分析其影响因素。 结果 化疗后,两组患者肿瘤体积小于化疗前(P < 0.05),有效组患者肿瘤体积小于无效前(P < 0.05)。两组患者化疗后6月生存率的差异无统计学意义(P > 0.05);化疗后1年,有效组患者生存率高于无效组(P < 0.05)。单因素分析结果显示:临床分期、分化程度以及化疗周期可能是肿瘤体积的影响因素(P < 0.05)。Logistic回归分析结果显示:临床分期、分化程度及化疗周期是非小细胞肺癌患者肿瘤体积的影响因素(P < 0.05)。ROC曲线分析结果表明肿瘤体积对非小细胞肺癌患者新辅助化疗疗效的预测价值,敏感度为0.732,特异性为0.800。 结论 基于CT测量的肿瘤体积对非小细胞肺癌患者新辅助化疗的疗效有一定的评估价值。 Abstract:Objective To analyze the evaluation value of neoadjuvant chemotherapy in patients with non-small cell lung cancer (NSCLC) based on tumor volume measured by CT. Methods Seventy- four patients with NSCLC who received neoadjuvant chemotherapy in our hospital from May 2019 to May 2020 were selected. After chemotherapy, they were divided into effective group (n=51) and ineffective group (n=23) based on pathological results. Tumor volume of all patients was measured by CT. Its influencing factors were analyzed by univariate and Logistic multivariate regression analysis. Results After chemotherapy, the tumor volume of 2 groups was significantly smaller than before chemotherapy (P < 0.05). The tumor volume of effective group was significantly smaller than before ineffective (P < 0.05). There was no significant difference in 6-month survival rate between 2 groups after chemotherapy (P > 0.05). One year after chemotherapy, the survival rate of effective group was significantly higher than that of ineffective group (P < 0.05). Univariate analysis showed that clinical stage, degree of differentiation and chemotherapy cycle were influencing factors of tumor volume (P < 0.05). Logistic regression analysis showed that clinical stage, differentiation degree and chemotherapy cycle were the influencing factors of tumor volume in patients with NSCLC (P < 0.05). ROC curve analysis showed that the sensitivity and specificity of tumor volume in predicting the efficacy of neoadjuvant chemotherapy in NSCLC patients were 0.732 and 0.800. Conclusion Tumor volume measured by CT has certain value in evaluating the efficacy of neoadjuvant chemotherapy in patients with NSCLC. -
Key words:
- CT /
- tumor volume /
- non-small cell lung cancer /
- neoadjuvant chemotherapy /
- assessment
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图 1 化疗前后非小细胞肺癌患者肺部CT图像
Figure 1. Lung CT images of NSCLC patients before and after chemotherapy. A: Right upper lung non-small cell lung cancer before chemotherapy; B: Right upper lung non-small cell lung cancer after chemotherapy; C: Before chemotherapy for non-small cell lung cancer of left upper lung; D: Left upper lung non-small cell lung cancer after chemotherapy.
表 1 化疗前后两组患者肿瘤体积大小及不同时期生存率比较
Table 1. Comparison of tumor size before and after chemotherapy and survival at different periods in the two groups
Index Time Effective group(n=51) Invalid group(n=23) t/χ2 P Gross tumor volume(cm3, Mean±SD) Before chemotherapy 83.21±5.29 82.25±5.43 0.717 0.476 After chemotherapy 55.25±4.14 80.86±5.02 23.030 < 0.001 Survival rate [n(%)] 6 months after chemotherapy 48(94.12) 20(86.96) 1.091 0.296 1 year after chemotherapy 37(60.78) 11(47.83) 4.252 0.039 表 2 影响肿瘤体积的单因素分析
Table 2. Univariate analysis affecting tumor volume [n(%)]
Index Withdrawal rate≥30%(n=53) Withdrawal rate < 30%(n=21) χ2 P Gender 0.182 0.669 Male 38(71.70) 14(66.67) Female 15(28.30) 7(33.33) Age (years) 0.113 0.737 ≥60 35(66.04) 13(61.90) < 60 18(33.96) 8(38.10) Clinical stages 10.441 0.001 Ⅰ designated time 23(43.40) 5(23.81) Ⅱ designated time 18(33.96) 3(14.29) Ⅲ designated time 12(55.64) 13(61.90) History of smoking 2.293 0.130 Have 25(47.17) 14(66.67) None 28(52.83) 7(33.33) Degree of differentiation 7.230 0.007 Low 18(33.96) 4(19.05) Middle 20(37.74) 4(19.05) High 15(28.30) 13(61.90) Chemotherapy cycle (years) 13.000 < 0.001 ≥1 43(81.13) 8(38.10) < 1 10(18.87) 13(61.90) Bronchial wall invasion 0.170 0.684 Have 20(37.74) 9(42.86) None 33(62.26) 12(57.14) 表 3 影响肿瘤体积的多因素Logistic回归分析
Table 3. Multivariate Logistic regression analysis affecting tumor volume
Index β SE Wald P OR 95% CI Clinical stages 0.53 0.21 8.460 0.012 1.699 1.126-2.564 Degree of differentiation 0.48 0.15 10.240 0.001 1.616 1.204-2.168 Chemotherapy cycle 0.51 0.18 8.028 0.005 1.170 1.655-2.370 -
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