RECIST标准评价食管癌临床分期的化疗效果

Evaluation of Chemotherapeutic Efficacy in Clinical Staging of Esophageal Cancer with RECIST Criteria

目的以食管钡餐X线片和CT扫描结合的检测结果确定食管癌临床T分期的依据,探讨用于RECIST标准对食管癌化疗疗效的评价效果。方法选择未行手术和放疗的食管癌83例,根据食管钡餐X线片病变长度和CT扫描管壁厚度以及病变与周围组织器官的关系,将病变局部分为T1、T2a、T2b、T3a、T3b、T4期,并结合区域淋巴结及远处转移对应临床分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期。应用FLP方案化疗2个周期,比较食管钡餐X线片与CT扫描的食管病变长度的结果,按照RECIST标准评价食管癌化疗疗效。结果83例中T1、T2a、T2b、T3a、T3b、T4期分别为7、11、15、26、19、5例,对应临床分期Ⅱ、Ⅲ、Ⅳ期分别为13、37、33例。食管钡餐X线片与CT扫描的食管平均病变长度分别为(4.6±1.4)cm和(4.8±0.7)cm,差异有统计学意义(t=3.58,P<0.05)。化疗疗效CR 2例,PR35例,SD 34例,PD 12例,RR45%。结论RECIST标准更适用于评价食管钡餐X线片和CT扫描确定的食管癌临床分期的化疗疗效。

Objective To explore the clinical T staging of esophageal cancer according to the combined results of barium meal X-ray film and CT scan,in order to find the suitability of evaluation of chemotherapeutic efficacy in esophageal cancer with RECIST criteria.Methods 83 esophageal cancer patients with no treatments of surgery and radiotherapy were selected.According to the primary lesion length in barium meal,as well as the thickness of the esophageal wall and the invasion of the surrounding organs in CT scan,the primary lesions were divided into T1,T2a,T2b,T3a,T3b and T4,corresponding to clinical stagingⅠ,Ⅱ,Ⅲ,and Ⅳ with evaluation of regional lymph nodes invasion and other metastases.After 2 cycles of chemotherapy using FLP regimen,primary lesion length in barium meal X-ray film and CT scan was compared with that of pre-therapy.The chemotherapeutic efficacy in esophageal cancer was assessed by RECIST criteria.Results Among the 83 cases,there were 7,11,15,26,19,the 5 cases respectively for T1,T2a,T2b,T3a,T3b and T4 stage,corresponding with 13,37 and 33 cases for clinical stagingⅡ,Ⅲ and Ⅳ.The mean length of primary lesions in esophagus taken by barium meals and CT scans was respectively（4.6±1.4） and（4.8±0.7）cm.There was statistical significance（t=3.58,P〈0.05）.According to RECIST criteria,the chemotherapeutic results for these esophageal cancer patients were CR for 2 cases,PR for 35 cases,SD for 34 cases,PD for 12 cases,RR for 45%.Conclusion RECIST criteria is more suitable to the evaluation of the chemotherapy efficacy in esophageal cancer,the clinical staging was classified by the results of barium meals and CT scans.