MSCT Monitoring Of Therapeutic Response In Bone Metastases Of Lung Cancer Patients Treated With Ibandronate

Objective:To assess the therapeutic response in bone metastases of lung cancer patients treated with ibandronate by analyzing the CT classification change and CT value change. And to evaluate the existence and CT features of bone flare phenomena, in order to improve the recognition of the phenomena. Methods:The clinical and image data of 45 patients with bone metastases of lung cancer were analyzed prior to treatment and 3,6 months after treatment.45 patients’bone CT value were analyzed prior to therapy and at 3, 6 months of post-treatment. And the CT features and CT value change between bone flare phenomena group and progressive disease (PD) group were compared. Results:For the treatment of bone metastases of three different types, compared the CT value of the 3,6 months of post-treatment with pre-treatment,and the comparison for the CT value of the 6 and 3 months of post-treatment, the distinction had statistically significant. No significant differences were detected for any comparison for the of normal-appearing bone tissues (P >0.05).The CT classification changed for 45 patients after treatment. Compared with pre-treatment group, the proportion of the sclerotic metastases increased (from 26.0% to57.7%) in effective group, The distinction had statistically significant (p<0.05); Compared with pre-treatment group, the proportion of the sclerotic metastases descented (from 40.0% to37.2%) in none-effective group (p<0.05). The incidence of bone flare phenomena is 6.7%(3/45), in this group bone metastases showed no lesions decrease at 3 months, the average bone density increase (p<0.05).In contrast, in PD group (n=5) lesions showed a mixed pattern with some increasing and others decreasing in bone density, the average bone density decrease (P>0.05).Compared with the sclerosis of lytic lesions, lysis in sclerotic or mixed lesions, lesions with new periosteal reaction of the bone flare phenomena and PD, the distinction had statistically significant (p<0.05); there were no statistically significant difference in increase of density in osteosclerotic lesions (p>0.05). Conclusions:The change of CT classification and CT value can be used as one of means of monitoring the efficacy of bone metastases of lung cancer treated with ibandronate. In addition, When MSCT used for monitoring of therapeutic response in bone metastases of lung cancer patients treated with ibandronate, the bone flare phenomena exists, and the change of CT features contributes to the differential diagnosis of bone flare phenomena and progressive disease.