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目的评价MRI是否能够显示乳腺癌病人新辅助化疗的治疗前差异,并监测早期治疗反应。方法搜索PubMed、Cochrane图书馆、Medline和Embase数据库中截止至2012年1月1日的文献。初步选择后,按照预先确定的入组/出组标准选择文献。两名研究者采用提取表格评价实验内容。结果在15项研究中,大部分样本有限并采用不同的实验设计,包括31个不同的参数。最常用的研究参数是肿瘤直径或体积,Ktrans、kep、Ve和表观扩散系数(ADC)。两项或很少研究中分析了其他参数。肿瘤直径、体积和血流动力参数在出现治疗反应和无治疗反应者之间无治疗前差异。两个研究显示ADC值在两组间存在治疗前差异。大部分影像学参数对于早期治疗反应的监测,均出现不同程度的变化。结论采用治疗前的MRI区分新辅助化疗的有应答与无应答组,以及采用MRI监测早期治疗反应,根据目前有限的研究结果和不同的实验设计证据尚不足。因此,乳腺MRI对于评价化疗反应的价值尚不确定。
Objective To evaluate whether MRI can show pretreatment differences in neoadjuvant chemotherapy in patients with breast cancer and monitor early treatment response. Methods The PubMed, Cochrane Library, Medline and Embase databases were searched as of January 1, 2012. After the initial selection, the documents are selected according to the predetermined entry / exit criteria. Two researchers used an extraction form to evaluate the experiment. Results Of the 15 studies, most of the samples were finite and used different experimental designs, including 31 different parameters. The most commonly used study parameters were tumor diameter or volume, Ktrans, kep, Ve and apparent diffusion coefficient (ADC). Other parameters were analyzed in two or fewer studies. Tumor diameter, volume, and hemodynamic parameters did not differ between treatments with and without treatment response. Two studies showed that there was pre-treatment difference in ADC values between the two groups. Most of the imaging parameters for the monitoring of early response to treatment, there are varying degrees of change. Conclusions Pre-treatment MRI distinguishes between responders and non-responders to neoadjuvant chemotherapy, as well as using MRI to monitor early response to treatment, based on the limited current research and different experimental design evidence. Therefore, the value of breast MRI in evaluating the response to chemotherapy is uncertain.