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3.0T-MRI表观扩散系数预测肺腺癌脑转移全脑放疗联合化疗疗效
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Abstract:
目的：探讨表观扩散系数(ADC)对肺腺癌多发脑转移全脑放疗联合全身化疗疗效的预测作用。方法：选取青岛大学附属医院2019年7月~2023年7月收治的60例肺腺癌合并多发脑转移行WBRT联合化疗的患者，于治疗前、治疗开始后12周内行磁共振弥散加权成像检查测定ADC值。依据实体瘤的疗效评价标准(RECIST)评价疗效，讨论治疗前MRI扩散加权成像表观扩散系数(pre-ADCmean)、δADC值与放化疗疗效之间的关系。结果：60例患者中同步放化疗治疗有效者32例，无效者28例。治疗有效组pre-ADCmean高于治疗无效组(P < 0.05)。ROC分析结果显示，pre-ADCmean值预测肺腺癌多发脑转移患者同步放化疗疗效的曲线下面积(AUC) > 0.70，有一定预测价值。结论：3.0T-MRI扩散加权成像表观扩散系数可预测肺腺癌多发脑转移行全脑放疗联合化疗疗效。
Objective: The objective was to evaluate the performance of ADC as a predictor of treatment outcomes associated with WBRT and chemotherapeutic agents in patients affected by lung adenocarcinoma (LUAD) originating in brain metastases (BMs). Methods: A retrospective analysis was conducted of 60 patients with LUAD with BMs who underwent WBRT and chemotherapy at the Affiliated Hospital of Qingdao University from July 2019 to July 2023, and measured the ADC value by DWI imaging before and within 12 weeks after treatment. According to the response evaluation criteria in solid tumors (RECIST), the efficacy was evaluated, and the relationships between pre-ADCmean and δADC values on MRI diffusion-weighted imaging and the efficacy of radiotherapy and chemotherapy were discussed. Results: Among the 60 patients, there were 32 responded to chemoradiotherapy, while 28 did not. The pre-ADCmean values of the effective group was higher than that of the ineffective group (P < 0.05). The ROC analysis showed that the pre-ADCmean value had a predictive value for the efficacy of concurrent chemoradiotherapy in patients with multiple brain metastases from lung adenocarcinoma, with an area under the curve (AUC) of >0.70. Conclusion: The apparent diffusion coefficient of 3.0T-MRI diffusion-weighted imaging can predict the efficacy of whole brain radiotherapy combined with chemotherapy for multiple brain metastases from lung adenocarcinoma.
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