Background/Objectives: To correlate size changes in undifferentiated pleomorphic sarcoma (UPS) on magnetic resonance imaging (MRI) after neoadjuvant chemoradiation therapy (nCRT) with pathological response, risk of local recurrence, and therapeutic regimens.Methods: This retrospective study analyzed clinical, pathological, and imaging data from 39 biopsy-proven UPS subjects. Four readers measured the tumor dimensions before and after nCRT, including two perpendicular axial diameters and the longest coronal/sagittal diameter. Three cross-sectional areas and bounding volume were also calculated. Responders (pR) were defined as having ≤10% viable cells and non-responders (pNR) as having more. Inter-reader agreement was evaluated using Kendall’s concordance coefficient. Changes in tumor size were compared between pR and pNR using one-way ANOVA and Tukey’s HSD test for multiple comparisons of means.Results: pR showed a greater increase in size across all measurements compared to pNR. For the longest axial diameter, the mean increase was 30% ± 35% for pR and 14% ± 31% for pNR, with a mean difference (pR-pNR) of 16% (95% CI: 6–27%,p= 0.003). In tumors treated with radiotherapy alone, pR exhibited larger size increases in all dimensions compared to pNR. In contrast, in the chemoradiation group, pR showed a slight increase, while pNR generally shrank, although these differences did not reach statistical significance. Notably, pNR with local recurrence exhibited a reduction in all tumor dimensions compared to pNR without local recurrence.Conclusions: This exploratory study suggests that tumor size changes may predict pathological response and local recurrence after nCRT in UPS; however, the small sample size limits the generalizability of these findings.
背景/目的：探讨未分化多形性肉瘤（UPS）在新辅助放化疗（nCRT）后磁共振成像（MRI）上肿瘤大小的变化与病理反应、局部复发风险及治疗方案之间的相关性。 方法：本回顾性研究分析了39例经活检证实的UPS患者的临床、病理及影像学资料。四位阅片者测量了nCRT前后的肿瘤尺寸，包括两个垂直的轴位直径及最长的冠状位/矢状位直径，并计算了三个横截面积及外接体积。病理应答者（pR）定义为存活细胞≤10%，非应答者（pNR）定义为存活细胞>10%。采用Kendall一致性系数评估阅片者间一致性。使用单因素方差分析和Tukey HSD检验进行均值多重比较，分析pR与pNR间肿瘤大小变化的差异。 结果：与pNR相比，pR在所有测量维度上均表现出更显著的肿瘤增大。就最长轴位直径而言，pR的平均增大幅度为30% ± 35%，pNR为14% ± 31%，平均差异（pR-pNR）为16%（95% CI: 6–27%, p=0.003）。在仅接受放疗的肿瘤中，pR在所有维度上的增大程度均大于pNR。相比之下，在放化疗联合治疗组中，pR呈现轻微增大，而pNR普遍缩小，但这些差异未达到统计学显著性。值得注意的是，伴有局部复发的pNR在所有肿瘤维度上均较无局部复发的pNR呈现缩小趋势。 结论：本探索性研究表明，肿瘤大小变化可能预测UPS患者nCRT后的病理反应及局部复发风险，但样本量较小限制了研究结果的普适性。
肿瘤(癌症)患者之家