Predicting clinical outcomes in chordoma patients receiving immunotherapy: a comparison between volumetric segmentation and RECIST

BMC Cancer

Research Article

Nicholas J. Patronas¹  Les R. Folio¹  James L. Gulley²  Jennifer L. Marté²  Kathleen E. Fenerty³  Christopher R. Heery³ 

[1] Cancer Imaging Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;Genitourinary Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Room 13N208, 20892, Bethesda, MD, USA;

关键词: Chordoma;    Volumetric;    RECIST;    Radiologic;    Response criteria;   

DOI  :  10.1186/s12885-016-2699-x

 received in 2015-10-28, accepted in 2016-08-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe Response Evaluation Criteria in Solid Tumors (RECIST) are the current standard for evaluating disease progression or therapy response in patients with solid tumors. RECIST 1.1 calls for axial, longest-diameter (or perpendicular short axis of lymph nodes) measurements of a maximum of five tumors, which limits clinicians’ ability to adequately measure disease burden, especially in patients with irregularly shaped tumors. This is especially problematic in chordoma, a disease for which RECIST does not always adequately capture disease burden because chordoma tumors are typically irregularly shaped and slow-growing. Furthermore, primary chordoma tumors tend to be adjacent to vital structures in the skull or sacrum that, when compressed, lead to significant clinical consequences.MethodsVolumetric segmentation is a newer technology that allows tumor burden to be measured in three dimensions on either MR or CT. Here, we compared the ability of RECIST measurements and tumor volumes to predict clinical outcomes in a cohort of 21 chordoma patients receiving immunotherapy.ResultsThere was a significant difference in radiologic time to progression Kaplan-Meier curves between clinical outcome groups using volumetric segmentation (P = 0.012) but not RECIST (P = 0.38). In several cases, changes in volume were earlier and more sensitive reflections of clinical status.ConclusionRECIST is a useful evaluation method when obvious changes are occurring in patients with chordoma. However, in many cases, RECIST does not detect small changes, and volumetric assessment was capable of detecting changes and predicting clinical outcome earlier than RECIST. Although this study was small and retrospective, we believe our results warrant further research in this area.

【 授权许可】

CC BY   
© The Author(s). 2016