Background
Methods
Patients and clinical follow-up
Treatment
Imaging techniques
Imaging analysis
Target lesions
Tumor size
Tumor density
TTP
Tumor response assessment according to RECIST version 1.1 and the Choi criteria
RECIST version 1.1 | Choi criteria | |
---|---|---|
CR | Disappearance of all lesions No new lesions | Disappearance of all lesions No new lesions |
PR | A decrease in sizea of ≥30% | A decrease in sizea of ≥10% or a decrease in tumor density (HU) of ≥15% in CT No new lesions No obvious progression of immeasurable disease |
SD | Neither sufficient shrinkage to qualify for PR nor a sufficient increase to qualify for PD | Does not meet the criteria for CR, PR, or PD No symptomatic deterioration attributable to tumor progression |
PD | An increase in sizea of ≥20% New lesions New intratumoral nodules or increase in the size of the existing intratumoral nodules | An increase in tumor sizea of ≥10% and does not meet the criteria for PR based on tumor density (HU) in CT New lesions New intratumoral nodules or an increase in the size of the existing intratumoral nodules |
Statistical analysis
Results
Study population
Characteristic | |
---|---|
Age (yr), n (%) | |
Median | 47.5 |
Range | 28–61 |
Sex, male/female, n (%) | 8 (44.4)/10 (55.6) |
Primary lesion | |
Pancreas | 14 (77.8) |
Rectum | 1 (5.6) |
Unknown origin | 3 (16.7) |
Site of target lesions, n (%) | |
Pancreas (primary tumor) | 11 (25.0) |
Liver | 25 (56.8) |
Mesenteric lymph node | 1 (2.3) |
Retroperitoneal lymph node | 3 (6.8) |
Pelvic cavity | 4 (9.1) |
Pathological classification, n (%) | |
Grade 1 | 2 (11.1) |
Grade 2 | 14 (77.8) |
Grade 3 | 2 (11.1) |
Tumor functionality, n (%) | |
Nonfunctioning | 16 (88.9) |
Functioning | 2 (11.1) |
Previous treatments, n (%) | |
None | 11 (61.1) |
Surgery | 4 (22.2) |
Octreotide | 1 (5.6) |
Transarterial chemoembolization | 1 (5.6) |
Transarterial chemoembolization & Octreotide | 1 (5.6) |
Duration of sunitinib (months) | |
Median | 6.8 |
Range | 1.0–22.7 |
Time between initiation and first evaluation (months) | |
Median | 2.3 |
Range | 1.4–3.1 |
Duration of follow-up (months) | |
Median | 17.3 |
Range | 4.3–47.9 |
Early assessment of changes in tumor size and density
Early response assessed using RECIST 1.1 and the Choi criteria
Parameter | RECIST 1.1 | Choi criteria | ||
---|---|---|---|---|
Size | Density | Size | Density | |
PR | −43.4 | −17.8 | −24.9 | −16.8 |
SD | 3.5 | −5.8 | 3.8 | −5.0 |
PD | 21.0 | 1.2 | 18.2 | 3.2 |
Z value | 13.888 | 4.256 | 13.263 | 6.352 |
P value | 0.001 | 0.119 | 0.001 | 0.042 |
Assessment of TTP according to RECIST 1.1 and the Choi criteria
No. of patient | Change in tumor size (%) | Change in tumor density (%) | RECIST 1.1 response | Choi response | TTP (m) |
---|---|---|---|---|---|
1 | −34 | −15 | PR | PR | 16.6 |
2 | −42 | −21 | PR | PR | 6.4 |
3 | −45 | 11 | PR | PR | 18.5 |
4 | −50 | −54 | PR | PR | 13.0 |
5 | −15 | 3 | SD | PR | 7.4 |
6 | 5 | −15 | SD | PR | 22.8 |
7 | −6 | −18 | SD | PR | 20.5 |
8 | −9 | −34 | SD | PR | 2.4 |
9 | −3 | −8 | SD | SD | 10.8 |
10 | 5 | −5 | SD | SD | 15.1 |
11 | 4 | −3 | SD | SD | 5.9 |
12 | 3 | −5 | SD | SD | 12.6 |
13 | 11 | 5 | SD | PD | 5.7 |
14 | 11 | −1 | PDa
| PD | 1.4 |
15 | 27 | 9 | PD | PD | 3.1 |
16 | 15 | −4 | PDa
| PD | 2.3 |
17 | 24 | 1 | PD | PD | 2.1 |
18 | 21 | 8 | PD | PD | 2.5 |