Đặc điểm hình ảnh cắt lớp vi tính 256 dãy trong chẩn đoán và theo dõi điều trị ung thư phổi biểu mô tuyến có đột biến EGFR

SUMMARY:

Purpose: The characteristics of 256-slice computer tomography in patients with EGFR-mutated lung adenocarcinoma and the tumor response to targeted therapy according to RECIST 1.1 criteria were taken into investigation in this study.

Methods: 32 patients with EGFR- mutated lung adenocarcinoma received TKI (tyrosine kinase inhibitor) were underwent 256-slice CT scanner before treatment and 3 months, 6 months of treatment, from July 2017 to July 2019 at Friendship Hospital.

Results: Before therapy, on 256-slice CT scanner in patients with EGFR-mutated lung adenocarcinoma, we observed tumors on the right in 56.3% of patients, tumors in the upper lobe in 56.3%, tumors size larger than 3 cm in 81.3%, lobulated or spiculated margin in 100%, pleural effusion in 50%, air bronchogram in 34.4% and cavitation in 3.1%. Metastases was present in lymph nodes in 68.8%, followed by metastatic deposits in lung (56.3%), bone (53.1%), brain (9.4%), adrenal gland (9.4%) and liver (6.3%). After 3 months of treatment , the percentage of partial response was 34.4%, stable disease was 59.4% and progressive disease was 6.3%; after 6 months, these ratio were 40.6%, 43.8% and 15.6% respectively.

Conclusion: Common CT scanner features in patients with EGFRmutated lung adenocarcinoma were lobulated or spiculated margin, size larger than 3cm and pleural effusion; cavitation was rarely noticed. Metastases usually presented in lymph node, lung and bone. The disease control rate at 3 months and 6 months of therapy were 93.7% and 84.4% respectively. CT scanner is a potential tool for evaluating tumor response and improving effective treatment in patients with lung cancer received TKI.

Keywords: lung adenocarcinoma, EGFR mutation, computed tomography.