Xue Feiyu, Lin Lilie L, Dehdashti Farrokh, Miller Tom R, Siegel Barry A, Grigsby Perry W
Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Gynecol Oncol. 2006 Apr;101(1):147-51. doi: 10.1016/j.ygyno.2005.10.005. Epub 2005 Nov 2.
We evaluated the prognostic significance of tumor metabolic activity on pretreatment positron emission tomography using the glucose analog F-18 fluorodeoxyglucose (FDG-PET) in patients with carcinoma of the cervix undergoing radiotherapy with or without concurrent chemotherapy.
We studied 96 consecutive patients who underwent FDG-PET prior to initiation of radiotherapy with or without concurrent chemotherapy for carcinoma of the cervix. Pretreatment FDG uptake of the primary tumor was assessed with the semiquantitative standardized uptake value (SUV) and correlated with disease-free and overall survival. Survival was estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed with the logistic likelihood ratio test and the Cox proportional hazards model, respectively. RESULTS.: Five-year disease-free survivals in patients with maximal SUV <10.2 and > or =10.2 were 71% and 52% (P = 0.0289) respectively, while overall survivals were 72% and 69% (P = 0.4), respectively. On multivariate analysis, lymph node metastasis on FDG-PET was found to be predictive of disease-free survival (P < 0.0001). Both the SUV for FDG and FIGO Stage I disease were found to be marginally predictive of disease-free survival (P = 0.055 and P = 0.058, respectively).
FDG uptake within primary cervical cancer, as measured by SUV, is predictive of disease-free survival in patients undergoing radiotherapy for cervical cancer. High FDG uptake may be useful in identifying patients who may require more aggressive initial therapy.
我们评估了在接受放疗（联合或不联合同步化疗）的宫颈癌患者中，使用葡萄糖类似物F-18氟脱氧葡萄糖（FDG-PET）进行治疗前正电子发射断层扫描时肿瘤代谢活性的预后意义。
我们研究了96例连续的宫颈癌患者，这些患者在开始放疗（联合或不联合同步化疗）之前接受了FDG-PET检查。通过半定量标准化摄取值（SUV）评估原发肿瘤的治疗前FDG摄取情况，并将其与无病生存期和总生存期相关联。采用Kaplan-Meier法估计生存期。分别使用逻辑似然比检验和Cox比例风险模型进行单因素和多因素分析。结果：最大SUV<10.2和≥10.2的患者的5年无病生存率分别为71%和52%（P = 0.0289），而总生存率分别为72%和69%（P = 0.4）。多因素分析显示，FDG-PET上的淋巴结转移可预测无病生存期（P < 0.0001）。发现FDG的SUV和FIGO I期疾病对无病生存期均有边缘性预测价值（分别为P = 0.055和P = 0.058）。
通过SUV测量的原发性宫颈癌内的FDG摄取可预测接受宫颈癌放疗患者的无病生存期。高FDG摄取可能有助于识别可能需要更积极初始治疗的患者。
