肿瘤疗效评价标准中英文.doc
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1、Response Evaluation Criteria in Solid Tumors (RECIST) Quick Reference:EligibilityOnly patients with measurable disease at baseline should be included in protocols where objective tumor response is the primary endpoint. Measurable disease - the presence of at least one measurable lesion. If the measu
2、rable disease is restricted to a solitary lesion, its neoplastic nature should be confirmed by cytology/histology. Measurable lesions - lesions that can be accurately measured in at least one dimension with longest diameter 20 mm using conventional techniques or 10 mm with spiral CT scan.Non-measura
3、ble lesions - all other lesions, including small lesions (longest diameter 20 mm with conventional techniques or 10 mm with spiral CT scan), i.e., bone lesions, leptomeningeal disease, ascites, pleural/pericardial effusion, inflammatory breast disease, lymphangitis cutis/pulmonis, cystic lesions, an
4、d also abdominal masses that are not confirmed and followed by imaging techniques; and.All measurements should be taken and recorded in metric notation, using a ruler or calipers. All baseline evaluations should be performed as closely as possible to the beginning of treatment and never more than 4
5、weeks before the beginning of the treatment. The same method of assessment and the same technique should be used to characterize each identified and reported lesion at baseline and during follow-up. Clinical lesions will only be considered measurable when they are superficial (e.g., skin nodules and
6、 palpable lymph nodes). For the case of skin lesions, documentation by color photography, including a ruler to estimate the size of the lesion, is recommended. Methods of Measurement CT and MRI are the best currently available and reproducible methods to measure target lesions selected for response
7、assessment. Conventional CT and MRI should be performed with cuts of 10 mm or less in slice thickness contiguously. Spiral CT should be performed using a 5 mm contiguous reconstruction algorithm. This applies to tumors of the chest, abdomen and pelvis. Head and neck tumors and those of extremities u
8、sually require specific protocols.Lesions on chest X-ray are acceptable as measurable lesions when they are clearly defined and surrounded by aerated lung. However, CT is preferable. When the primary endpoint of the study is objective response evaluation, ultrasound (US) should not be used to measur
9、e tumor lesions. It is, however, a possible alternative to clinical measurements of superficial palpable lymph nodes, subcutaneous lesions and thyroid nodules. US might also be useful to confirm the complete disappearance of superficial lesions usually assessed by clinical examination.The utilizatio
10、n of endoscopy and laparoscopy for objective tumor evaluation has not yet been fully and widely validated. Their uses in this specific context require sophisticated equipment and a high level of expertise that may only be available in some centers. Therefore, the utilization of such techniques for o
11、bjective tumor response should be restricted to validation purposes in specialized centers. However, such techniques can be useful in confirming complete pathological response when biopsies are obtained.Tumor markers alone cannot be used to assess response. If markers are initially above the upper n
12、ormal limit, they must normalize for a patient to be considered in complete clinical response when all lesions have disappeared.Cytology and histology can be used to differentiate between PR and CR in rare cases (e.g., after treatment to differentiate between residual benign lesions and residual mal
13、ignant lesions in tumor types such as germ cell tumors).Baseline documentation of “Target” and “Non-Target” lesionsAll measurable lesions up to a maximum of five lesions per organ and 10 lesions in total, representative of all involved organs should be identified as target lesions and recorded and m
14、easured at baseline. Target lesions should be selected on the basis of their size (lesions with the longest diameter) and their suitability for accurate repeated measurements (either by imaging techniques or clinically). A sum of the longest diameter (LD) for all target lesions will be calculated an
15、d reported as the baseline sum LD. The baseline sum LD will be used as reference by which to characterize the objective tumor. 所有目旳病灶旳最长长径总和将会被计算和汇报成基线旳长径和,该和作为有效缓和记录旳参照基线。All other lesions (or sites of disease) should be identified as non-target lesions and should also be recorded at baseline. Meas
16、urements of these lesions are not required, but the presence or absence of each should be noted throughout follow-up. Response CriteriaEvaluation of target lesions* Complete Response (CR):Disappearance of all target lesions* Partial Response (PR):At least a 30% decrease in the sum of the LD of targe
17、t lesions, taking as reference the baseline sum LD* Progressive Disease (PD):At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions* Stable Disease (SD):Neither sufficie
18、nt shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment startedEvaluation of non-target lesions* Complete Response (CR):Disappearance of all non-target lesions and normalization of tumor marker level* Incomplete Response/
19、Stable Disease (SD): Persistence of one or more non-target lesion or/and maintenance of tumor marker level above the normal limits* Progressive Disease (PD):Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions (1) (1)Although a clear progression of “non
20、 target” lesions only is exceptional, in such circumstances, the opinion of the treating physician should prevail and the progression status should be confirmed later on by the review panel (or study chair).Evaluation of best overall responseThe best overall response is the best response recorded fr
21、om the start of the treatment until disease progression/recurrence (taking as reference for PD the smallest measurements recorded since the treatment started). In general, the patients best response assignment will depend on the achievement of both measurement and confirmation criteria Target lesion
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