在全新辅助治疗中,通过使用内镜和放射学方法结合中间和最终分析的作用
Kamil Erozkan1, David Liska1, Ayda Oktem1
1Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
American journal of surgery
|November 22, 2024
概括
最终的直肠磁共振成像 (MRI) 和柔性半导体镜 (FS) 在直肠癌中显示,在全新辅助治疗 (TNT) 后,完全响应 (CR) 的一致性最高. 临时MRI可能不需要.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
背景情况:
- 结直肠癌的治疗包括全新辅助疗法 (TNT),其次是重新分期.
- 准确评估完整反应 (CR) 对治疗决策至关重要.
- 灵活的半导体显微镜 (FS) 和直肠磁共振成像 (MRI) 用于重新分阶段.
研究的目的:
- 为了比较FS,MRI及其组合在TNT后评估CR的性能.
- 在中间阶段 (i) 和最后阶段 (f) 评估与CR的一致性.
主要方法:
- 在2015-2022年期间,对208名接受TNT治疗的直肠癌患者进行了回顾性分析.
- 恢复评估包括FS和MRI.
- 使用加权-κ测试分析了与CR的一致性.
主要成果:
- 总体的CR率为42.3% .
- 只有最终FS (fFS) 具有最高的CR检测灵敏度 (68.2%),并具有中等一致性 (κ=0.46).
- 结合了中间-最终FS (iFS-fFS) 和最终FS-最终MRI (fFS-fMRI) 的组合,显示出与单独的fFS相似的一致性.
结论:
- 最终的MRI和FS的组合提供了与CR的最高一致性和更好的灵敏度.
- 临时MRI可能不会提供显著的额外临床价值,并且可能会被遗漏在重新分期的协议中.
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