摘要
Sorafenib is an effective anti-angiogenic treatment forhepatocellular carcinoma(HCC). The assessment of tumor progression in patients treated with sorafenib is crucial to help identify potentially-resistant patients,avoiding unnecessary toxicities. Traditional methods to assess tumor progression are based on variations in tumor size and provide unreliable results in patients treated with sorafenib. New methods to assess tumor progression such as the modified Response Evaluation Criteria in Solid Tumors or European Association for the Study of Liver criteria are based on imaging to measure the vascularization and tumor volume(viable or necrotic). These however fail especially when the tumor response results in irregular development of necrotic tissue. Newer assessment techniques focus on the evaluation of tumor volume,density or perfusion. Perfusion computed tomography and Dynamic ContrastEnhanced-UltraS ound can measure the vascularization of HCC lesions and help predict tumor response to antiangiogenic therapies. Mean Transit Time is a possible predictive biomarker to measure tumor response. Volumetric techniques are reliable,reproducible and time-efficient and can help measure minimal changes in viable tumor or necrotic tissue,allowing the prompt identification of non-responders. Volume ratio may be a reproducible biomarker for tumor response. Larger trials are needed to confirm the use of these techniques in the prediction of response to sorafenib.
Sorafenib is an effective anti-angiogenic treatment forhepatocellular carcinoma （HCC）. The assessment oftumor progression in patients treated with sorafenibis crucial to help identify potentially-resistant patients,avoiding unnecessary toxicities. Traditional methodsto assess tumor progression are based on variationsin tumor size and provide unreliable results in patientstreated with sorafenib. New methods to assess tumorprogression such as the modified Response EvaluationCriteria in Solid Tumors or European Association forthe Study of Liver criteria are based on imaging tomeasure the vascularization and tumor volume （viableor necrotic）. These however fail especially when thetumor response results in irregular development ofnecrotic tissue. Newer assessment techniques focus onthe evaluation of tumor volume, density or perfusion.Perfusion computed tomography and Dynamic Contrast-Enhanced-UltraSound can measure the vascularizationof HCC lesions and help predict tumor response to antiangiogenictherapies. Mean Transit Time is a possiblepredictive biomarker to measure tumor response.Volumetric techniques are reliable, reproducible andtime-efficient and can help measure minimal changesin viable tumor or necrotic tissue, allowing the promptidentification of non-responders. Volume ratio may be areproducible biomarker for tumor response. Larger trialsare needed to confirm the use of these techniques in theprediction of response to sorafenib.
