The use of perfusion CT for the evaluation of therapy combining AZD2171 with gefitinib in cancer patients

The purpose of this study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (CTP) in evaluating the hemodynamic response of tumors in the chest and abdomen treated with a combination of AZD2171 and gefitinib. Thirteen patients were examined just before and every 4-6 weeks af...

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Bibliographic Details
Published in:European radiology 2007-07, Vol.17 (7), p.1700-1713
Main Authors: Meijerink, Martijn R, van Cruijsen, Hester, Hoekman, Klaas, Kater, Matthijs, van Schaik, Cors, van Waesberghe, Jan Hein T M, Giaccone, Giuseppe, Manoliu, Radu A
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Aged
Angiography
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Contrast Media - administration & dosage
Disease Progression
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Gefitinib
Humans
Image Processing, Computer-Assisted
Injections, Intravenous
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Male
Mediastinal Neoplasms - diagnostic imaging
Mediastinal Neoplasms - drug therapy
Middle Aged
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - drug therapy
Pelvic Neoplasms - diagnostic imaging
Pelvic Neoplasms - drug therapy
Pleural Neoplasms - diagnostic imaging
Pleural Neoplasms - drug therapy
Prognosis
Quinazolines - administration & dosage
Quinazolines - adverse effects
Tomography, Spiral Computed
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Summary:The purpose of this study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (CTP) in evaluating the hemodynamic response of tumors in the chest and abdomen treated with a combination of AZD2171 and gefitinib. Thirteen patients were examined just before and every 4-6 weeks after starting therapy. Following intravenous injection of a contrast agent, dynamic image acquisition was obtained at the level of a selected tumor location. To calculate perfusion, the maximum-slope method was used. Pre-treatment average perfusion for extra-hepatic masses was 84 ml/min/100 g, for liver masses arterial perfusion was 25 ml/min/100 g, and a portal perfusion of 30 ml/min/100 g was found. After the administration of AZD2171 and gefitinib, in extra-hepatic masses an initial decrease in perfusion of 18% was followed by a plateau and in liver masses an initial decrease of 39% within the lesions and of 36% within a rim region surrounding the lesions was followed by a tendency to recovery of hepatic artery flow. In conclusion, CTP is feasible in showing changes of perfusion induced by anti-angiogenic therapy.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-006-0425-9