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Abstract

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  2. Abstract

We investigated the validity and inter-criteria reproducibility between RECIST (Response Evaluation Criteria in Solid Tumors) guidelines and WHO (World Health Organization) criteria, considering the decrease in patient numbers resulting from inclusion of the minimum lesion size criterion introduced in RECIST guidelines. RECIST guidelines are based on unidimensional measurement and exclusion of small lesions from measurement. The aims of the study were to examine: (1) the effect of the minimum lesion size criterion, (2) the validity of unidimensional and bidimensional measurements, i.e., their relationship with tumor volume, (3) the inter-criteria reproducibility between current RECIST guidelines and previous WHO criteria. One hundred and twenty patients with non-small cell lung cancer (NSCLC) in clinical trials were evaluated. By applying the minimum lesion size criterion, six cases became ineligible without any influence on precision of tumor volume measurement. In the validity study, actual tumor volume was regarded as the gold standard. Although the unidimensional measurement had a lower correlation with tumor volume value than the bidimensional measurement, both the unidimensional measurement and bidimensional measurement correlated sufficiently well with tumor volume changes and the assessed tumor volume response. In the inter-criteria reproducibility study between RECIST guidelines and WHO criteria, the response rate assessed by RECIST guidelines (19.3%) was almost the same as that assessed by WHO criteria (20.0%). In conclusion, RECIST guidelines are adequate for evaluating tumor response to chemotherapy in terms of both validity in relation to tumor volume and inter-criteria reproducibility with the WHO criteria.

Abbreviations:
WHO

World Health Organization

RECIST

Response Evaluation Criteria in Solid Tumors

NSCLC

non-small cell lung cancer

CDDP

cisplatin

CT

computed tomography

MRI

magnetic resonance imaging

CR

complete response

PR

partial response

SD

stable disease

PD

progressive disease

CI

confidence intervals

  • 1
    Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG. New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 2000; 92: 20516.
  • 2
    Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer 1981; 47: 20714.
  • 3
    Sohaib SA, Turner B, Hanson JA, Farquharson M, Oliver RT, Reznek RH. CT assessment of tumour response to treatment: comparison of linear, cross-sectional and volumetric measures of tumour size. Br J Radiol 2000; 73: 117884.
  • 4
    Werner-Wasik M, Xiao Y, Pequignot E, Curran WJ, Hauck W. Assessment of lung cancer response after nonoperative therapy: tumor diameter, bidimensional product, and volume. A serial CT scan-based study. Int J Radiat Oncol Biol Phys 2001; 51: 5661.
  • 5
    Warren KE, Patronas N, Aikin AA, Albert PS, Balis FM. Comparison of one-, two-, and three-dimensional measurements of childhood brain tumors. J Natl Cancer Inst 2001; 93: 14015.
  • 6
    James K, Eisenhauer E, Christian M, Terenziani M, Vena D, Muldal A, Therasse P. Measuring response in solid tumors: unidimensional versus bidimensional measurement. J Natl Cancer Inst 1999; 91: 5238.
  • 7
    SobinLH, WittekindCh., editors. UICC TNM Classification of malignant tumours. 5th ed. New York : John Wiley & Sons Inc; 1997.
  • 8
    Breiman RS, Beck JW, Korobkin M, Glenny R, Akwari OE, Heaston DK, Moore AV, Ram PC. Volume determinations using computed tomography. Am J Roentgenol 1982; 138: 32933.
  • 9
    Van Hoe L, Van Cutsem E, Vergote I, Baert AL, Bellon E, Dupont P, Marchal G. Size quantification of liver metastases in patients undergoing cancer treatment: reproducibility of one-, two-, and three-dimensional measurements determined with spiral CT. Radiology 1997; 202: 6715.
  • 10
    Bozcuk HS, Ravi R, Turner B, Tsetis D, Thomas JM, Chan O, Reznek R, Hendry WF, Oliver RT. Computed tomography 21 days after chemotherapy, three-dimensional estimates of metastatic volume and the need for surgery in patients with germ cell cancer. BJU Int 2000; 86: 70713.