论著摘要 |【PET】用贝伐单抗治疗复发性胶质母细胞瘤患者风险分层的定量成像生物标志物(双语版)

2017-08-25 13:59:29 admin 13

Quantitative Imaging Biomarkers for Risk Stratification of Patients with Recurrent GlioblastomaTreated with Bevacizumab.

发表日期:2017.5.11    来源:Neuro Oncol.

作者:Grossmann P1,2Narayan V1Chang K3Rahman R1Abrey L4Reardon DA5Schwartz LH6Wen PY7Alexander BM1Huang R3Aerts HJWL1,3,2.

作者介绍:

    1.Departments of Radiation Oncology and.

    2.Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, USA.

    3.Departments of Radiology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

    4.Product Development, Pharma Division, F. Hoffmann-La Roche Ltd., Basel, Switzerland.

    5.Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.

    6.Department of Radiology, Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York City, New York, USA.

    7.Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.


背景

贝伐单抗的抗血管生成治疗是复发性胶质母细胞瘤使用最广泛的治疗方法,但治疗反应差异很大,患者选择的有效生物标志物不可用。为此,我们确定基于磁共振成像(MRI)的新型定量影像组学策略是否有有助于对该患者群体的生存和进展进行非侵入性分层。

Antiangiogenic therapy with bevacizumab is the most widely used treatment option for recurrent glioblastoma, but therapeutic response varies substantially and effective biomarkers for patient selection are not available. To this end, we determine whether novel quantitative radiomic strategies on the basis of magnetic-resonance-imaging (MRI) have the potential to noninvasively stratify survival and progression in this patient population.

方法

在最初的126名患者群中,我们确定了治疗前MRI基线中放射照相表型的一组独特的特征。这些选择的特征在来自多中心BRAIN试验的第二组中165名患者的进行了评估,具有预期获得的临床和成像数据。使用基线成像和治疗后6周时的第一次随访成像,在3,6,9个月内对总生存期(OS),无进展生存期(PFS)和进展的预后价值进行评估。

In an initial cohort of 126 patients, we identified a distinct set of features representative of the radiographic phenotype on baseline (pre-treatment) MRI. These selected features were evaluated on a second cohort of 165 patients from the multicenter BRAIN trial with prospectively acquired clinical and imaging data. Features were evaluated in terms of prognostic value for overall survival (OS), progression-free survival (PFS), and progression within three, six, and nine months using baseline imaging and first follow-up imaging at six weeks post-treatment initiation.

结果

在基线成像中导出的特征的多变量分析导致验证数据中OS(HR = 2.5; log-rank p = 0.001)和PFS(HR = 4.5; log-rank p = 2.1×10-5)的显著分层。这些分层比临床或体积协变量更强(置换测试FDR<0.05)。来自增强后T1加权成像的预后纹理异质性特征(信息相关性)的单变量分析显示,在三个月内进程的患者的分数显著更高(Wilcoxon检验p = 8.8×10-8)。通常情况下,与增强前T2加权成像相比,增强后T1加权成像获得的特征预后能力更高。


Multivariable analysis of features derived at baseline imaging resulted in significant stratification of OS (HR=2.5; log-rank p=0.001) and PFS (HR=4.5; log-rank p=2.1x10-5) in validation data. These stratifications were stronger compared to clinical or volumetric covariates (permutation test FDR<0.05). Univariable analysis of a prognostic textural-heterogeneity feature (information-correlation) derived from post-contrast T1-weighted imaging revealed significantly higher scores for patients who progressed within three months (Wilcoxon test p=8.8x10-8). Generally, features derived from post-contrast T1-weighted imaging yielded higher prognostic power as compared to pre-contrast enhancing T2-weighted imaging.

结论

影像组学可为接受贝伐单抗治疗的复发性胶质母细胞瘤患者的生存和进展提供预后价值。这些结果可能导致定量治疗前生物标志物的发展,以使用护理成像标准来预测贝伐单抗的优势。

Radiomics provides prognostic value for survival and progression in patients with recurrent glioblastoma receiving bevacizumab treatment. These results could lead to the development of quantitative pre-treatment biomarkers to predict benefit from bevacizumab using standard of care imaging.

关键词

贝伐单抗,胶质母细胞瘤,影像组学,复发,生存

BEVACIZUMAB; GLIOBLASTOMA; RADIOMICS; RECURRENT; SURVIVAL


慧影医疗科技(北京)有限公司

地点:北京市海淀区中关村东升科技园B2-C103

电话:400-890-9020

邮箱:radcloud@huiyihuiying.com

关闭
图片
图片
  • 人工智能诊断云平台