COMPARISON OF WHO AND RECIST RESPONSE CRITERIA IN LOCALLY ADVANCED BREAST CANCERA DESCRIPTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 65
Abstract
BACKGROUND The current trend in management of Locally Advanced Breast Cancer (LABC) has changed from radical surgery to multimodality approach involving surgery, radiotherapy and chemotherapy. The efficacy of anticancer drugs is assessed by objective tumour response. The standard WHO response criteria have been used traditionally, however, with improvement in imaging modalities, new guidelines using unidimensional measurement has been proposed by the Response Evaluation Criteria in Solid Tumours [RECIST] group. Our study was aimed to compare the standard WHO response criteria with the new RECIST criteria in Locally Advanced Breast Cancer [LABC]. MATERIALS AND METHODS Data were collected from 52 patients with locally advanced breast cancer to compare the two response assessment methods. All patients were biopsy-proven infiltrating ductal carcinoma cases and were evaluated completely including metastatic workup. Clinical measurement of the tumour was done using callipers. Contrast enhanced CT scan of thorax was done to assess tumour size and nodal status. Three cycles of chemotherapy [Paclitaxel and Adriamycin] was given at 21 days interval. Post-chemotherapy CECT scan was done two weeks after the third cycle of chemotherapy and the tumour size was assessed. Clinical measurement of the tumour was also done post chemotherapy. WHO and RECIST response criteria were assessed in all patients and the results were compared using kappa Ƙ statistic to test concordance for overall response rate. RESULTS WHO criteria showed complete response in 10/52, partial response in 13/52 and 29/52 had no response. According to RECIST criteria, 8/52 had complete response, 20/52 had a partial response and 24/52 had no response. The response rate according to WHO criteria was 44.2%. With RECIST criteria the response rate was 53.8%. Seven patients were reclassified. There was good agreement between the unidimensional and bidimensional criteria in 22 of 23 responses (95.7%). The kappa Ƙ statistic for concordance for overall response was 0.733. CONCLUSION It is concluded from our study that the new RECIST criteria is comparable to the standard WHO criteria in evaluating locally advanced breast cancer. The RECIST criteria is a simpler measurement tool which can be used in daily practice and also gives a more accurate way of assessment about tumour response.
Authors and Affiliations
Vishnu Kumar Sundararaju
Keywords
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- EP ID EP231674
- DOI 10.14260/Jemds/2017/1016
- Views 83
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