影像学评估免疫治疗后肿瘤假性进展和超进展

Imaging progresses for evaluating pseudoprogression and hyperprogression of tumor during immunotherapy

免疫治疗过程中,肿瘤可出现假性进展或超进展。实体瘤疗效评价标准(RECIST)协作组优化了免疫治疗实体瘤疗效的评价标准,以提高识别肿瘤假性进展的能力;但目前对于超进展尚缺乏统一诊断标准,部分研究以肿瘤生长速率(TGR)等动力学指标评价肿瘤加速生长的动态特征。影像组学及MR功能成像在评估肿瘤免疫治疗方面展现出巨大潜力。本文对影像学评估免疫治疗致肿瘤假性进展和超进展的研究现状进行综述。

Tumor pseudoprogression and hyperprogression could occurred during immunotherapy.The response evaluation criteria in solid tumors(RECIST)working group optimized the evaluation criteria of the efficacy of immunotherapy for solid tumors,hence improved the ability of recognizing pseudoprogressive disease.Meanwhile,there is no unified evaluative criteria for hyperprogression.Some studies taken tumor growth rate(TGR)and other kinetic indexes to reflect the dynamic characteristics of accelerated growth of tumor.Radiomics and functional MRI showed great potential in evaluating tumor immunotherapy.The status of imaging evaluation on tumor pseudoprogression and hyperprogression during immunotherapy were reviewed in this article.