Measuring tumor response and shape change on CT: esophageal cancer as a paradigm

Annals of Oncology : Official Journal of the European Society for Medical Oncology
L H SchwartzG K Schwartz

Abstract

Accurate response assessment is essential for evaluating new cancer treatments. We evaluated the impact of Response Evaluation Criteria in Solid Tumors (RECIST), World Health Organization (WHO) criteria and tumor shape on response assessment in patients with metastatic esophageal cancer. In 19 patients with metastatic esophageal cancer in a phase II trial of bryostatin-1 and paclitaxel, response was retrospectively assessed for 89 lesions with RECIST and WHO criteria on baseline and serial follow-up CT scans. The eccentricity factor (EF) was introduced for measuring the degree to which tumor shape diverges from a perfect sphere [EF = radical1-(LPD/MD)(2), where LPD is the largest perpendicular diameter and MD is the maximal diameter]. The disagreement rate in best overall response categorization between RECIST (unidimensional) and WHO (bidimensional) criteria was 26.3%. Change in eccentricity was significantly greater (P < 0.01) for patients with disagreement (mean 0.31, range 0-0.91). When the short axis was used for unidimensional lymph node measurement, disagreement between WHO and RECIST lessened. Response assessment by WHO and RECIST differs substantially. Greater change in eccentricity is associated with greater discordan...Continue Reading

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Feb 14, 2008·Cancer Chemotherapy and Pharmacology·Geoffrey Y KuGary K Schwartz
Jul 16, 2008·Breast Cancer Research and Treatment·Uwe GüthGad Singer
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