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Erschienen in:

01.08.2013 | Chest

Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy

verfasst von: Nunzia Tacelli, Teresa Santangelo, Arnaud Scherpereel, Alain Duhamel, Valérie Deken, Ernst Klotz, Alexis Cortot, Jean-Jacques Lafitte, Frédéric Wallyn, Jacques Remy, Martine Remy-Jardin

Erschienen in: European Radiology | Ausgabe 8/2013

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Abstract

Objectives

To determine whether CT can depict early perfusion changes in lung cancer treated by anti-angiogenic drugs, allowing prediction of response.

Methods

Patients with non-small cell lung cancer, treated by conventional chemotherapy with (Group 1; n = 17) or without (Group 2; n = 23) anti-vascular endothelial growth factor (anti-VEGF) drug (bevacizumab) underwent CT perfusion before (TIME 0) and after 1 (TIME 1), 3 (TIME 2) and 6 (TIME 3) cycles of chemotherapy. The CT parameters evaluated included: (1) total tumour vascular volume (TVV) and total tumour extravascular flow (TEF); (2) RECIST (Response Evaluation Criteria in Solid Tumours) measurements. Tumour response was also assessed on the basis of the clinicians’ overall evaluation.

Results

In Group 1, significant reduction in perfusion was identified between baseline and: (1) TIME 1 (TVV, P = 0.0395; TEF, P = 0.015); (2) TIME 2 (TVV, P = 0.0043; TEF, P < 0.0001); (3) TIME 3 (TVV, P = 0.0034; TEF, P = 0.0005) without any significant change in Group 2. In Group 1: (1) the reduction in TVV at TIME 1 was significantly higher in responders versus non-responders at TIME 2 according to RECIST (P = 0.0128) and overall clinicians’ evaluation (P = 0.0079); (2) all responders at TIME 2 had a concurrent decrease in TVV and TEF at TIME 1.

Conclusion

Perfusion CT demonstrates early changes in lung cancer vascularity under anti-angiogenic chemotherapy that may help predict therapeutic response.

Key Points

• Perfusion CT has the potential of providing in vivo information about tumour vasculature.

• CT depicts early and specific perfusion changes in NSCLC under anti-angiogenic drugs.

• Specific therapeutic effects of anti-angiogenic drugs can be detected before tumour shrinkage.

• Early perfusion changes can help predict therapeutic response to anti-angiogenic treatment.

• Perfusion CT could be a non-invasive tool to monitor anti-angiogenic treatment.

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Titel: Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy
verfasst von: Nunzia Tacelli
Teresa Santangelo
Arnaud Scherpereel
Alain Duhamel
Valérie Deken
Ernst Klotz
Alexis Cortot
Jean-Jacques Lafitte
Frédéric Wallyn
Jacques Remy
Martine Remy-Jardin
Publikationsdatum: 01.08.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2821-2

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Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy