目的探讨基于锥光束乳腺CT(cone-bean breast CT,CBBCT)图像的放射组学模型对乳腺癌新辅助治疗病理完全缓解(pathological complete response,pCR)的预测价值。方法回顾性分析2022年1月至2023年5月于广西医科大学附属肿瘤医院接受新辅...目的探讨基于锥光束乳腺CT(cone-bean breast CT,CBBCT)图像的放射组学模型对乳腺癌新辅助治疗病理完全缓解(pathological complete response,pCR)的预测价值。方法回顾性分析2022年1月至2023年5月于广西医科大学附属肿瘤医院接受新辅助治疗的106例女性乳腺癌患者的CBBCT图像。将患者按8∶2的比例随机分为训练组和测试组。共提取2264个放射组学特征,采用特征筛选器与机器学习分类器交叉组合的方案建立放射组学模型。使用受试者工作特征(receiver operating characteristic,ROC)曲线评估模型的性能,利用决策曲线分析(decision curve analysis,DCA)比较训练组和测试组不同阈值概率下的净收益。结果L2范数正则化-决策树模型在训练组的曲线下面积(area under the curve,AUC)为0.941(95%CI:0.897~0.984),准确率为86.9%,特异度为94.2%,敏感度为75.0%;在测试组的AUC为0.732(95%CI:0.518~0.947),准确率为72.7%,特异度为85.7%,敏感度为50.0%。无论在训练组还是测试组均有最大净收益。结论基于CBBCT图像的L2范数正则化-决策树预测模型在预测乳腺癌新辅助治疗pCR上有较好的性能表现,可为乳腺癌个体化治疗和及时调整化疗方案提供有价值的信息。展开更多
目的:了解影像学在直肠癌新辅助治疗疗效预测中的研究进展。方法:检索近年来有关直肠癌新辅助治疗疗效预测的相关文献并进行综述。结果:讨论了对于影像学新技术在直肠癌疗效预测中的最新进展,并且评估了新辅助治疗对直肠癌疗效的常用成...目的:了解影像学在直肠癌新辅助治疗疗效预测中的研究进展。方法:检索近年来有关直肠癌新辅助治疗疗效预测的相关文献并进行综述。结果:讨论了对于影像学新技术在直肠癌疗效预测中的最新进展,并且评估了新辅助治疗对直肠癌疗效的常用成像方法及新技术的优点和缺点。结论:对于临床治疗而言,我们应该准确地利用各种影像学方法的优势,采用综合的方法来对直肠癌新辅助治疗疗效进行全方位、客观、准确的评估,为临床提供决策依据,最终提高直肠癌患者的总体生存期。Objective: To review the progress in imaging techniques for predicting the efficacy of neoadjuvant therapy in rectal cancer. Methods: A literature review was conducted on recent studies related to the prediction of neoadjuvant therapy efficacy in rectal cancer. Results: The latest advances in imaging technologies for assessing the efficacy of neoadjuvant therapy in rectal cancer were discussed. Additionally, common imaging methods and new technologies used to evaluate neoadjuvant treatment efficacy were assessed in terms of their advantages and limitations. Conclusion: For clinical practice, it is essential to accurately leverage the strengths of various imaging modalities. A comprehensive approach should be adopted to provide a thorough, objective, and precise evaluation of the efficacy of neoadjuvant therapy in rectal cancer, which will assist in clinical decision-making and ultimately improve the overall survival of rectal cancer patients.展开更多
目的:观察TAC方案联合内分泌新辅助治疗对HR阳性/HER-2阴性乳腺癌的疗效。方法:选取2020年9月至2024年6月125例HR阳性/HER-2阴性乳腺癌患者,分观察组60例、对照组65例,观察组据月经状态再分为绝经前绝经后,对照组行TAC化疗6周期,观察组...目的:观察TAC方案联合内分泌新辅助治疗对HR阳性/HER-2阴性乳腺癌的疗效。方法:选取2020年9月至2024年6月125例HR阳性/HER-2阴性乳腺癌患者,分观察组60例、对照组65例,观察组据月经状态再分为绝经前绝经后,对照组行TAC化疗6周期,观察组在此基础上加内分泌治疗,新辅助治疗6周期后手术,对观察组与对照组两组间、观察组组内及不同病理分期的观察组与对照组在MP分级、病理完全缓解(pCR)率、ORR、Ki-67变化值、不良反应发生率进行分析比较。结果:观察组与对照组pCR率无统计学差异,观察组ORR高于对照组(78.33% vs 60.00%),差异有统计学意义(χ2 = 4.885, P = 0.021),观察组Ki-67变化值大于对照组(25.45% ± 11.51% vs 20.34% ± 11.10%),差异有统计学意义(t = 2.527, P = 0.013),潮热发生率观察组高于对照组。观察组Stage II的ORR高于Stage III (92.86% vs 44.44%),差异有统计学意义(P t = 2.037, P = 0.046),其余各项结果无统计学差异;观察组内绝经前、后患者各项结果无统计学差异。结论:化疗联合内分泌新辅助治疗可以提高HR阳性/HER-2阴性乳腺癌的ORR率、改善MP分级以及降低Ki-67,且安全性良好。Objective: To observe the therapeutic effect of the TAC regimen combined with neoadjuvant endocrine therapy in HR-positive/HER-2-negative breast cancer. Methods: A total of 125 patients with HR-positive/HER-2-negative breast cancer from September 2020 to June 2024 were selected and divided into an observation group (n = 60) and a control group (n = 65). The observation group was further divided into premenopausal and postmenopausal subgroups according to menstrual status. The control group received 6 cycles of TAC chemotherapy, and the observation group received endocrine therapy in addition to TAC chemotherapy. Surgery was performed after 6 cycles of neoadjuvant therapy. The MP grade, pathological complete response (pCR) rate, objective response rate (ORR), change value of Ki-67, and incidence of adverse reactions were analyzed and compared between the observation group and the control group, within the observation groups, and between the observation group and the control group in different pathological stages. Results: There was no significant difference in the pCR rate between the observation group and the control group. The ORR of the observation group was higher than that of the control group (78.33% vs 60.00%), with a significant difference (χ2 = 4.885, P = 0.021). The change value of Ki-67 in the observation group was greater than that in the control group (25.45% ± 11.51% vs 20.34% ± 11.10%), with a significant difference (t = 2.527, P = 0.013). The incidence of hot flashes in the observation group was higher than that in the control group. In the observation group, the objective response rate (ORR) in Stage II was higher than that in Stage III (92.86% vs 44.44%), and the difference was statistically significant (P P = 0.046). There was no statistical difference in the remaining results. There was no difference in the results between premenopausal and postmenopausal patients within the observation group. Conclusion: Chemotherapy combined with neoadjuvant endocrine therapy can improve the ORR, improve the MP grade, and reduce Ki-67 in HR-positive/HER-2-negative breast cancer, with good safety.展开更多
文摘目的探讨基于锥光束乳腺CT(cone-bean breast CT,CBBCT)图像的放射组学模型对乳腺癌新辅助治疗病理完全缓解(pathological complete response,pCR)的预测价值。方法回顾性分析2022年1月至2023年5月于广西医科大学附属肿瘤医院接受新辅助治疗的106例女性乳腺癌患者的CBBCT图像。将患者按8∶2的比例随机分为训练组和测试组。共提取2264个放射组学特征,采用特征筛选器与机器学习分类器交叉组合的方案建立放射组学模型。使用受试者工作特征(receiver operating characteristic,ROC)曲线评估模型的性能,利用决策曲线分析(decision curve analysis,DCA)比较训练组和测试组不同阈值概率下的净收益。结果L2范数正则化-决策树模型在训练组的曲线下面积(area under the curve,AUC)为0.941(95%CI:0.897~0.984),准确率为86.9%,特异度为94.2%,敏感度为75.0%;在测试组的AUC为0.732(95%CI:0.518~0.947),准确率为72.7%,特异度为85.7%,敏感度为50.0%。无论在训练组还是测试组均有最大净收益。结论基于CBBCT图像的L2范数正则化-决策树预测模型在预测乳腺癌新辅助治疗pCR上有较好的性能表现,可为乳腺癌个体化治疗和及时调整化疗方案提供有价值的信息。
文摘目的:了解影像学在直肠癌新辅助治疗疗效预测中的研究进展。方法:检索近年来有关直肠癌新辅助治疗疗效预测的相关文献并进行综述。结果:讨论了对于影像学新技术在直肠癌疗效预测中的最新进展,并且评估了新辅助治疗对直肠癌疗效的常用成像方法及新技术的优点和缺点。结论:对于临床治疗而言,我们应该准确地利用各种影像学方法的优势,采用综合的方法来对直肠癌新辅助治疗疗效进行全方位、客观、准确的评估,为临床提供决策依据,最终提高直肠癌患者的总体生存期。Objective: To review the progress in imaging techniques for predicting the efficacy of neoadjuvant therapy in rectal cancer. Methods: A literature review was conducted on recent studies related to the prediction of neoadjuvant therapy efficacy in rectal cancer. Results: The latest advances in imaging technologies for assessing the efficacy of neoadjuvant therapy in rectal cancer were discussed. Additionally, common imaging methods and new technologies used to evaluate neoadjuvant treatment efficacy were assessed in terms of their advantages and limitations. Conclusion: For clinical practice, it is essential to accurately leverage the strengths of various imaging modalities. A comprehensive approach should be adopted to provide a thorough, objective, and precise evaluation of the efficacy of neoadjuvant therapy in rectal cancer, which will assist in clinical decision-making and ultimately improve the overall survival of rectal cancer patients.
文摘目的:观察TAC方案联合内分泌新辅助治疗对HR阳性/HER-2阴性乳腺癌的疗效。方法:选取2020年9月至2024年6月125例HR阳性/HER-2阴性乳腺癌患者,分观察组60例、对照组65例,观察组据月经状态再分为绝经前绝经后,对照组行TAC化疗6周期,观察组在此基础上加内分泌治疗,新辅助治疗6周期后手术,对观察组与对照组两组间、观察组组内及不同病理分期的观察组与对照组在MP分级、病理完全缓解(pCR)率、ORR、Ki-67变化值、不良反应发生率进行分析比较。结果:观察组与对照组pCR率无统计学差异,观察组ORR高于对照组(78.33% vs 60.00%),差异有统计学意义(χ2 = 4.885, P = 0.021),观察组Ki-67变化值大于对照组(25.45% ± 11.51% vs 20.34% ± 11.10%),差异有统计学意义(t = 2.527, P = 0.013),潮热发生率观察组高于对照组。观察组Stage II的ORR高于Stage III (92.86% vs 44.44%),差异有统计学意义(P t = 2.037, P = 0.046),其余各项结果无统计学差异;观察组内绝经前、后患者各项结果无统计学差异。结论:化疗联合内分泌新辅助治疗可以提高HR阳性/HER-2阴性乳腺癌的ORR率、改善MP分级以及降低Ki-67,且安全性良好。Objective: To observe the therapeutic effect of the TAC regimen combined with neoadjuvant endocrine therapy in HR-positive/HER-2-negative breast cancer. Methods: A total of 125 patients with HR-positive/HER-2-negative breast cancer from September 2020 to June 2024 were selected and divided into an observation group (n = 60) and a control group (n = 65). The observation group was further divided into premenopausal and postmenopausal subgroups according to menstrual status. The control group received 6 cycles of TAC chemotherapy, and the observation group received endocrine therapy in addition to TAC chemotherapy. Surgery was performed after 6 cycles of neoadjuvant therapy. The MP grade, pathological complete response (pCR) rate, objective response rate (ORR), change value of Ki-67, and incidence of adverse reactions were analyzed and compared between the observation group and the control group, within the observation groups, and between the observation group and the control group in different pathological stages. Results: There was no significant difference in the pCR rate between the observation group and the control group. The ORR of the observation group was higher than that of the control group (78.33% vs 60.00%), with a significant difference (χ2 = 4.885, P = 0.021). The change value of Ki-67 in the observation group was greater than that in the control group (25.45% ± 11.51% vs 20.34% ± 11.10%), with a significant difference (t = 2.527, P = 0.013). The incidence of hot flashes in the observation group was higher than that in the control group. In the observation group, the objective response rate (ORR) in Stage II was higher than that in Stage III (92.86% vs 44.44%), and the difference was statistically significant (P P = 0.046). There was no statistical difference in the remaining results. There was no difference in the results between premenopausal and postmenopausal patients within the observation group. Conclusion: Chemotherapy combined with neoadjuvant endocrine therapy can improve the ORR, improve the MP grade, and reduce Ki-67 in HR-positive/HER-2-negative breast cancer, with good safety.
