Is it time to move from the Unidimensional RECIST 1.1 Response Assessment Criteria to a Volumetric Evaluation in the Present Era of Image-based Oncology? An Evaluation in Locally Advanced Head Neck Cancers Undergoing Treatment.

Autor: Kale P; Department of Radiotherapy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India; Department of Radiotherapy, Government Medical College, Nagpur, India. Electronic address: pournimakale03@gmail.com., Datta S; Department of Radiotherapy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India; Independent Researcher in Data Science, London, UK. Electronic address: snehadatta07@gmail.com., Kalbande P; Department of Radiotherapy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India; Department of Radiotherapy, University Hospital, Leicester, UK. Electronic address: pallavikalbande6@gmail.com., Aher P; Department of Radiotherapy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India. Electronic address: pratikaher@mgims.ac.in., Singh A; Department of Radiotherapy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India. Electronic address: ashoksingh@mgims.ac.in., Datta NR; Department of Radiotherapy, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India. Electronic address: niloydatta@mgims.ac.in.
Jazyk: angličtina
Zdroj: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2024 Oct; Vol. 36 (10), pp. 615-623. Date of Electronic Publication: 2024 Jul 20.
DOI: 10.1016/j.clon.2024.07.006
Abstrakt: Aims: Tumour response assessments, as per Response Evaluation Criteria in Solid Tumours (RECIST 1.1), are based on the sum of diameters (SODs) of the primary tumour (longest diameter) and/or short axis diameter of lymph nodes. This study evaluates the response categorisation as per RECIST 1.1 vs Computed tomography (CT) based volumetric assessment of RECIST (proposed as vRECIST) in locally advanced head and neck cancers (LAHNCs) undergoing treatment.
Material and Methods: The pre-treatment SODs and CT estimated tumour volumes were recorded in 45 LAHNCs treated with radiotherapy (RT), chemoradiotherapy (CTRT) or thermochemoradiotherapy (HTCTRT). Tumour responses were assessed independently as per RECIST 1.1 and vRECIST by two radiation oncologists and grouped into complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). These response groups were evaluated for the likely congruence of the two approaches, as categorised independently by these two observers.
Results: All patients in stages III (n = 7), IVA (n = 16) and IVB (n = 22) were inoperable and had received either RT alone (n = 1), CTRT (n = 12) or HTCTRT (n = 32). Based on SODs criteria of RECIST 1.1, of the 45 patients, 5 and 40 were grouped as PR and SD by the first observer, while this changed to 34 and 10, respectively and 1 PD, with vRECIST (p < 0.001). Similarly, for the second observer, the 4 PR and 41 SD grouped using RECIST 1.1 were recategorised to 34 PR, 10 SD, and 1 PD by vRECIST (p < 0.001). Thus, a mismatch of 66.6% and 68.8%, respectively, was evident by observers first and second in categorising SD based on SODs of RECIST 1.1 vs PR on vRECIST.
Conclusions: Treatment responses in LAHNCs assessed using SODs resulted in significant uncertainties and failed to reflect actual volumetric changes in tumours during treatment. It is perhaps time to consider replacing the SODs of RECIST 1.1 with vRECIST for unequivocal tumour response categorisation in the present era of image-based oncology practice.
(Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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