年恶性淋巴瘤疗效评价标准.pptx

“REVISED RESPONSE CRITERIA FOR MALIGNANT LYMPHOMA” J Clin Oncol 25:579-586. © 2007 by American Society of Clinical Oncology Cheson et al, J Clin Oncol 17:1244, 1999 In 1999, an International Working Group (IWG) of clinicians, radiologists, and pathologists with expertise in the evaluation and management of patients with Lymphoma published guidelines for response assessment and outcomes measurement. Response Criteria for Lymphoma Response Category Physical Examination Lymph Nodes Lymph Node Masses Bone Marrow CR Normal Normal Normal Normal CRu Normal Normal Normal Indeterminate Normal Normal > 75% decrease Normal or indeterminate PR Normal Normal Normal Positive Normal ≥50% decrease ≥50% decrease Irrelevant Decrease in liver/spleen ≥ 50% decrease ≥50% decrease Irrelevant Relapse/ progression Enlarging liver/spleen; new sites New or increased New or increased Reappearance Definitions of End Points for Clinical Trials End Point Response Category Definition Point of Measurement Overall survival All patients Death from any cause Entry onto trial Event-free survival CR, CRu, PR Failure or death from any cause Entry onto trial Progression-free survival All patients Disease progression or death from NHL Entry onto trial Disease-free survival CR, CRu Time to relapse First documentation of response Response duration CR, CRu, PR Time to relapse or progression First documentation of response Time to next treatment All patients Time when new treatment is needed Entry onto trial Cause-specific death All patients Death related to NHL Death Standardized response criteria provide uniform end points for clinical trials: Allowing for comparisons among studies Facilitating the identification of more effective therapies The widely used IWG criteria for response assessment of lymphoma are based predominantly on CT. It became clear that the International Working Group criteria warranted revision, because of identified limitations and the increased use of : [18F] fluorodeoxyglucose-positro