© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 6, 523-528,
March 17, 1999
© 1999 Oxford University Press
ARTICLES |
Measuring Response in Solid Tumors: Unidimensional Versus Bidimensional Measurement
Affiliations of authors: K. James, E. Eisenhauer, A. Muldal, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, ON, Canada; M. Christian, Cancer Therapy Evaluation Program, National Cancer Institute (NCI), Bethesda, MD; M. Terenziani, Division of Medical Oncology, NCI, Milan, Italy; D. Vena, The Emmes Corporation, Rockville, MD; P. Therasse, European Organization for Research and Treatment of Cancer, Data Center, Brussels, Belgium.
Correspondence to: Keith James, M.A., M.B., F.R.C.R., National Cancer Institute of Canada Clinical Trials Group, Queen's University, 82-84 Barrie St., Kingston, ON K7L 3N6, Canada (e-mail: jamesk{at}ncic.ctg.queensu.ca).
BACKGROUND: Tumor shrinkage is a common end point used in screening new cytotoxic
agents. The standard World Health Organization criterion for partial response is a 50% or
more decrease in the sum of the products of two measurements (the maximum diameter of a
tumor and the largest diameter perpendicular to this maximum diameter) of individual tumors.
However, theoretically, the simple sum of the maximum diameters of individual tumors is more
linearly related to cell kill than is the sum of the bidimensional products. It has been
hypothesized that the calculation of bidimensional products is unnecessary, and a 30%
decrease in the sum of maximum diameters of individual tumors (assuming spherical shape and
equivalence to a 50% reduction in the sum of the bidimensional products) was proposed as
a new criterion. We have applied the standard response and the new response criteria to the same
data to determine whether the same number of responses in the same patients would result.
METHODS: Data from 569 patients included in eight studies of a variety of cancers were
reanalyzed. The two response criteria were separately applied, and the results were compared
using the 
statistic. The importance of confirmatory measurements and the frequency of
nonspherical tumors were also examined. In addition, for a subset of 128 patients, a
unidimensional criterion for disease progression (30% increase in the sum of maximum
diameters) was applied and compared with the standard definition of a 25% increase in the
sum of the bidimensional products. RESULTS: Agreement between the unidimensional and
bidimensional criteria was generally found to be good. The statistic for concordance for
overall response was 0.95. CONCLUSION: We conclude that one dimensional measurement of
tumor maximum diameter may be sufficient to assess change in solid tumors.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L.-S. Tham, L. Wang, R. A. Soo, S.-C. Lee, H.-S. Lee, W.-P. Yong, B.-C. Goh, and N. H.G. Holford A Pharmacodynamic Model for the Time Course of Tumor Shrinkage by Gemcitabine + Carboplatin in Non-Small Cell Lung Cancer Patients Clin. Cancer Res., July 1, 2008; 14(13): 4213 - 4218. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Suzuki, H. Jacobsson, T. Hatschek, M. R. Torkzad, K. Boden, Y. Eriksson-Alm, E. Berg, H. Fujii, A. Kubo, and L. Blomqvist Radiologic Measurements of Tumor Response to Treatment: Practical Approaches and Limitations RadioGraphics, March 1, 2008; 28(2): 329 - 344. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Bissler, F. X. McCormack, L. R. Young, J. M. Elwing, G. Chuck, J. M. Leonard, V. J. Schmithorst, T. Laor, A. S. Brody, J. Bean, et al. Sirolimus for Angiomyolipoma in Tuberous Sclerosis Complex or Lymphangioleiomyomatosis N. Engl. J. Med., January 10, 2008; 358(2): 140 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L Scott, O Soepenberg, J Verweij, M. de Jonge, A. Th Planting, D McGovern, P Principe, R Obach, and C Twelves A multicentre phase I and pharmacokinetic study of BN80915 (diflomotecan) administered daily as a 20-min intravenous infusion for 5 days every 3 weeks to patients with advanced solid tumours Ann. Onc., March 1, 2007; 18(3): 569 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sandler, R. Gray, M. C. Perry, J. Brahmer, J. H. Schiller, A. Dowlati, R. Lilenbaum, and D. H. Johnson Paclitaxel-Carboplatin Alone or with Bevacizumab for Non-Small-Cell Lung Cancer N. Engl. J. Med., December 14, 2006; 355(24): 2542 - 2550. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Zhao, L. H. Schwartz, C. S. Moskowitz, M. S. Ginsberg, N. A. Rizvi, and M. G. Kris Lung Cancer: Computerized Quantification of Tumor Response--Initial Results Radiology, December 1, 2006; 241(3): 892 - 898. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. C. Jaffe Measures of Response: RECIST, WHO, and New Alternatives J. Clin. Oncol., July 10, 2006; 24(20): 3245 - 3251. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. A. Mayr, W. T. C. Yuh, T. Taoka, J. Z. Wang, D. H. Wu, J. F. Montebello, S. L. Meeks, A. C. Paulino, V. A. Magnotta, M. Adli, et al. Serial therapy-induced changes in tumor shape in cervical cancer and their impact on assessing tumor volume and treatment response. Am. J. Roentgenol., July 1, 2006; 187(1): 65 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H. Schwartz, J. A. C. Colville, M. S. Ginsberg, L. Wang, M. Mazumdar, J. Kalaigian, H. Hricak, D. Ilson, and G. K. Schwartz Measuring tumor response and shape change on CT: esophageal cancer as a paradigm Ann. Onc., June 1, 2006; 17(6): 1018 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Galanis, J. C. Buckner, M. J. Maurer, R. Sykora, R. Castillo, K. V. Ballman, B. J. Erickson, and for the North central cancer treatment Group Validation of neuroradiologic response assessment in gliomas: Measurement by RECIST, two-dimensional, computer-assisted tumor area, and computer-assisted tumor volume methods Neuro-oncol, April 1, 2006; 8(2): 156 - 165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Armato III, J. L. Ogarek, A. Starkey, N. J. Vogelzang, H. L. Kindler, M. Kocherginsky, and H. MacMahon Variability in mesothelioma tumor response classification. Am. J. Roentgenol., April 1, 2006; 186(4): 1000 - 1006. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. T. Zacharia, S. Saini, E. F. Halpern, and J. E. Sumner CT of Colon Cancer Metastases to the Liver Using Modified RECIST Criteria: Determining the Ideal Number of Target Lesions to Measure. Am. J. Roentgenol., April 1, 2006; 186(4): 1067 - 1070. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Shah, S. Kesari, R. Xu, T. T. Batchelor, A. M. O'Neill, F. H. Hochberg, B. Levy, J. Bradshaw, and P. Y. Wen Comparison of linear and volumetric criteria in assessing tumor response in adult high-grade gliomas Neuro-oncol, January 1, 2006; 8(1): 38 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Comoli, P. Pedrazzoli, R. Maccario, S. Basso, O. Carminati, M. Labirio, R. Schiavo, S. Secondino, C. Frasson, C. Perotti, et al. Cell Therapy of Stage IV Nasopharyngeal Carcinoma With Autologous Epstein-Barr Virus-Targeted Cytotoxic T Lymphocytes J. Clin. Oncol., December 10, 2005; 23(35): 8942 - 8949. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W A Weber PET for response assessment in oncology: radiotherapy and chemotherapy Br. J. Radiol., November 1, 2005; Supplement_28(1): 42 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Pagani, C. Sessa, F. Nole, E. Munzone, D. Crivellari, D. Lombardi, B. Thurlimann, D. Hess, R. Graffeo, M. Ruggeri, et al. Dose-finding study of weekly docetaxel, anthracyclines plus fluoropyrimidines as first-line treatment in advanced breast cancer Ann. Onc., October 1, 2005; 16(10): 1609 - 1617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Tait Advances in chemoradiation therapy in rectal cancer: the impact of imaging Br. J. Radiol., October 1, 2005; 78(Special_Issue_2): S131 - S137. [Full Text] [PDF]
|
|
|
|
|
|
A. L. Thomas, B. Morgan, M. A. Horsfield, A. Higginson, A. Kay, L. Lee, E. Masson, M. Puccio-Pick, D. Laurent, and W. P. Steward Phase I Study of the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of PTK787/ZK 222584 Administered Twice Daily in Patients With Advanced Cancer J. Clin. Oncol., June 20, 2005; 23(18): 4162 - 4171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. A. Weber Use of PET for Monitoring Cancer Therapy and for Predicting Outcome J. Nucl. Med., June 1, 2005; 46(6): 983 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Partridge, J. E. Gibbs, Y. Lu, L. J. Esserman, D. Tripathy, D. S. Wolverton, H. S. Rugo, E. S. Hwang, C. A. Ewing, and N. M. Hylton MRI Measurements of Breast Tumor Volume Predict Response to Neoadjuvant Chemotherapy and Recurrence-Free Survival Am. J. Roentgenol., June 1, 2005; 184(6): 1774 - 1781. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A. Moffat, T. L. Chenevert, T. S. Lawrence, C. R. Meyer, T. D. Johnson, Q. Dong, C. Tsien, S. Mukherji, D. J. Quint, S. S. Gebarski, et al. Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response PNAS, April 12, 2005; 102(15): 5524 - 5529. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Yeh, P. Slanetz, D. B. Kopans, E. Rafferty, D. Georgian-Smith, L. Moy, E. Halpern, R. Moore, I. Kuter, and A. Taghian Prospective Comparison of Mammography, Sonography, and MRI in Patients Undergoing Neoadjuvant Chemotherapy for Palpable Breast Cancer Am. J. Roentgenol., March 1, 2005; 184(3): 868 - 877. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. C. M. Straathof, C. M. Bollard, U. Popat, M. H. Huls, T. Lopez, M. C. Morriss, M. V. Gresik, A. P. Gee, H. V. Russell, M. K. Brenner, et al. Treatment of nasopharyngeal carcinoma with Epstein-Barr virus-specific T lymphocytes Blood, March 1, 2005; 105(5): 1898 - 1904. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Liu, S. Varghese, and S. D. Rabkin Oncolytic Herpes Simplex Virus Vector Therapy of Breast Cancer in C3(1)/SV40 T-antigen Transgenic Mice Cancer Res., February 15, 2005; 65(4): 1532 - 1540. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. O'Connell PET-CT Modification of RECIST Guidelines J Natl Cancer Inst, May 19, 2004; 96(10): 801 - 802. [Full Text] [PDF]
|
|
|
|
|
|
B. Morgan, A. L. Thomas, J. Drevs, J. Hennig, M. Buchert, A. Jivan, M. A. Horsfield, K. Mross, H. A. Ball, L. Lee, et al. Dynamic Contrast-Enhanced Magnetic Resonance Imaging As a Biomarker for the Pharmacological Response of PTK787/ZK 222584, an Inhibitor of the Vascular Endothelial Growth Factor Receptor Tyrosine Kinases, in Patients With Advanced Colorectal Cancer and Liver Metastases: Results From Two Phase I Studies J. Clin. Oncol., November 1, 2003; 21(21): 3955 - 3964. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. O. Park, S. I. Lee, S. Y. Song, K. Kim, W. S. Kim, C. W. Jung, Y. S. Park, Y.-H. Im, W. K. Kang, M. H. Lee, et al. Measuring Response in Solid Tumors: Comparison of RECIST and WHO Response Criteria Jpn. J. Clin. Oncol., October 1, 2003; 33(10): 533 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H. Schwartz, M. Mazumdar, W. Brown, A. Smith, and D. M. Panicek Variability in Response Assessment in Solid Tumors: Effect of Number of Lesions Chosen for Measurement Clin. Cancer Res., October 1, 2003; 9(12): 4318 - 4323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K McHugh and S Kao Response evaluation criteria in solid tumours (RECIST): problems and need for modifications in paediatric oncology? Br. J. Radiol., July 1, 2003; 76(907): 433 - 436. [Full Text] [PDF]
|
|
|
|
|
|
V Trillet-Lenoir, G Freyer, P Kaemmerlen, A Fond, O Pellet, C Lombard-Bohas, J L Gaudin, G Lledo, R Mackiewicz, M C Gouttebel, et al. Assessment of tumour response to chemotherapy for metastatic colorectal cancer: accuracy of the RECIST criteria Br. J. Radiol., November 1, 2002; 75(899): 903 - 908. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A R Padhani and L Ollivier The RECIST criteria: implications for diagnostic radiologists Br. J. Radiol., November 1, 2001; 74(887): 983 - 986. [Full Text] [PDF]
|
|
|
|
|
|
K. E. Warren, N. Patronas, A. A. Aikin, P. S. Albert, and F. M. Balis Comparison of One-, Two-, and Three-Dimensional Measurements of Childhood Brain Tumors J Natl Cancer Inst, September 19, 2001; 93(18): 1401 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Esserman, E. Kaplan, S. Partridge, D. Tripathy, H. Rugo, J. Park, S. Hwang, H. Kuerer, D. Sudilovsky, Y. Lu, et al. MRI Phenotype Is Associated With Response to Doxorubicin and Cyclophosphamide Neoadjuvant Chemotherapy in Stage III Breast Cancer Ann. Surg. Oncol., July 1, 2001; 8(6): 549 - 559. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. L. Chenevert, L. D. Stegman, J. M. G. Taylor, P. L. Robertson, H. S. Greenberg, A. Rehemtulla, and B. D. Ross Diffusion Magnetic Resonance Imaging: an Early Surrogate Marker of Therapeutic Efficacy in Brain Tumors J Natl Cancer Inst, December 20, 2000; 92(24): 2029 - 2036. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Therasse, S. G. Arbuck, E. A. Eisenhauer, J. Wanders, R. S. Kaplan, L. Rubinstein, J. Verweij, M. Van Glabbeke, A. T. van Oosterom, M. C. Christian, et al. New Guidelines to Evaluate the Response to Treatment in Solid Tumors J Natl Cancer Inst, February 2, 2000; 92(3): 205 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. James, E. Eisenhauer, and P. Therasse Re: Measure Once or Twice Does It Really Matter? J Natl Cancer Inst, October 20, 1999; 91(20): 1780 - 1780. [Full Text] [PDF]
|
|
|
|
|
|
S. G. Hilsenbeck and D. D. V. Hoff Measure Once or Twice—Does It Really Matter? J Natl Cancer Inst, March 17, 1999; 91(6): 494 - 495. [Full Text] [PDF]
|
|