Comparison Of RECIST, EORTC And PERCIST Criteria For Response Evaluation Of Chemotherapy In Patients With Non-small Cell Lung Cancer

ObjectiveComparison the Response evaluation criteria in solid tumors(RECIST),European organizationfor research and treatment of cancer(EORTC) and PET response criteria in solid tumors(PERCIST)criteria for response evaluation in patients with advanced non-small cell lung cancer(NSCLC)treated with chemotherapy, providing objective basis for clinic to choose response evaluationcriteria.MethodsRetrospectively reviewed twenty-two patients with advanced non-small cell lungcancer(NSCLC), who received examination in The First Affiliated Hospital of JINAN UniversityPET/CT center between November2011and April2014. All the patients confirmed bypathological diagnosis (lung puncture or bronchoscopic biopsy). Of22patients,19patients weremen and3were women. age range50to81years, mean age59.5±7.9years.17patients wereadenocarcinoma,5patients were squamous cell carcinoma.6patients were stage III,16patientswere stage IV. All the patients treated with standard chemotherapy. The18F-FDG PET/CT (GEDiscovery Elite) scans were obtained before and after treatment. Patients with more than6hoursfasting, the blood glucose levels in normal range at each PET/CT scanning, and there were nosignificant difference between injected doses of18F-FDG and uptake times between PET/CTscanning before and after chemotherapy. All the data were analyze by the PET VCAR softwarewhich in the GE AW VolumeShore4.6workstation, then obtaining the results of RECIST, EORTCand PERCIST. The results of RECIST criteria include progression disease (PD), stable disease（SD），partial response（PR）and complete remission(CR). The results of EORTC and PERCISTcriteria include progressive metabolic disease(PMD), stable metabolic disease(SMD), partialmetabolic response(PMR) and complete metabolic response(CMR). Compare the response rateand analyze their consistency and difference. ResultsAccording to the RECIST criteria,8cases (36.4%) of PD,11cases (50%) of SD,3cases(13.6%) of PR,0cases (0%) of CR, the response rate（PR+CR）was13.6%.According to theEORTC criteria,5cases(22.7%) of PMD,6cases (27.3%) of SMD,11cases(50%) of PMR,0cases(0%) of CMR, the response rate（PMR+CMR）was50%.According to the PERCIST criteria,5cases(22.7%) of PMD,5cases (22.7%) of SMD,12cases(54.6%) of PMR,0cases(0%) of CMR,the response rat（ePMR+CMR）was54.6%.The response rate according to the RECIST criteria wassignificantly lower than according to the EORTC and PERCIST criteria.The inconsistent cases between RECIST and EORTC criteria were13(59.1%), there was apoor agreement in response classification between them(Kappa=0.171，p＜0.05). The inconsistentcases between RECIST and PERCIST criteria were14(63.6%), there was a poor agreement inresponse classification between them(Kappa=0.127，p＜0.05). The inconsistent cases betweenEORTC and PERCIST criteria were3(13.6%), there was a perfect agreement in responseclassification between them(Kappa=0.778，p＞0.05).ConclusionsThere was a significant difference between response rate of RECIST criteria (which basedon anatomical structure) and EORTC,PERCIST criteria(both of which based on metabolite) forresponse evaluation in patients with non-small cell lung cancer treated with chemotherapy. Therewas a perfect agreement between response rate of EORTC and PERCIST (both of which basedon metabolite) for response evaluation in patients with non-small cell lung cancer treated withchemotherapy.