CE-EUS显示造影剂弥散度可能是预测胰腺腺癌患者FOLFIRINOX化疗效果的工具。

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2025-03-01 DOI:10.1016/j.pan.2025.01.011

Mike J.P. de Jong , Foke van Delft , Fer D.W. Radstake , Tom H. Perik , Geke Litjens , Tanya M. Bisseling , Fons van der Sommen , Erwin-Jan M. van Geenen , John J. Hermans , Peter D. Siersema

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引用次数: 0

摘要

背景：胰腺导管腺癌（PDAC）的5年总生存率仍然很低，只有13%。化疗越来越多地被用作治疗（新）辅助和姑息性疾病。然而，化疗的总体生存效益必须与导致生活质量下降的显著副作用进行权衡。CE-EUS和弹性成像可以提供胰腺肿瘤血管化和弹性的额外信息。本研究的目的是研究对比增强内镜超声和/或弹性成像是否适合预测FOLFIRINOX的有效性。方法：单中心、前瞻性的概念验证研究，在接受EUS常规诊断检查的患者中，静脉注射造影剂并计算应变比。对照剂给药后，直接记录120 s的视频，然后用改进的局部密度随机游走（mLDRW）模型进行跟踪和拟合。结果：纳入17例患者。根据基于RECIST的横断面成像标准，11例患者化疗有效，6例无效。两组患者的对比弥散参数（κ1）分别为2.994 （IQR 1.670 ~ 5.170）和1.203 (IQR 0.953 ~ 1.756), p = 0.005。有效治疗组弹性应变比较高（20.9 vs 13.6, p = 0.138）。结论：这项概念验证研究表明，FOLFIRINOX有效的患者第一波对比剂的弥散参数高2.5倍，表明该参数可能是可靠的预测工具。

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Contrast agent dispersion visualized by CE-EUS may be a prediction tool for FOLFIRINOX chemotherapy effectiveness in patients with pancreatic adenocarcinoma

Background

Pancreatic ductal adenocarcinoma (PDAC) still has a dismal 5-year overall survival of 13 %. Chemotherapy is increasingly used as treatment in both (neo-) adjuvant and palliative conditions. However, the overall survival benefits of chemotherapy must be weighed against significant side effects leading to a reduction in quality of life. CE-EUS and elastography could provide additional information about the vascularization and elasticity of the pancreatic tumor. The aim of this study was to investigate if contrast-enhanced endoscopic ultrasound and/or elastography could be suitable to predict the effectiveness of FOLFIRINOX.

Methods

Single center, prospective proof-of-concept study in which intravenous contrast agent was administered and strain ratio was calculated in patients undergoing EUS in their regular diagnostic work-up. Directly after contrast administration, a video of 120 s was recorded and afterwards tracked and fitted by a Modified Local Density Random Walk (mLDRW) model.

Results

We included 17 patients. Based on cross-sectional imaging based RECIST criteria, chemotherapy treatment was effective in 11 patients and not effective in 6 patients. The contrast dispersion parameter (κ1) differed significantly between both groups in favor of the responders: 2.994 (IQR 1.670–5.170) vs 1.203 (IQR 0.953–1.756), p = 0.005. The elastography strain ratio was higher in the effectively treated group (20.9 vs 13.6, p = 0.138).

Conclusion

This proof-of-concept study showed that the dispersion parameter of the first wave of contrast was 2.5 times higher in patients in whom FOLFIRINOX was effective, suggesting that this parameter could possibly be a reliable prediction tool.

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.