Charnley Natalie, West Catharine M, Barnett Carolyn M, Brock Catherine, Bydder Graeme M, Glaser Mark, Newlands Ed S, Swindell Ric, Matthews Julian, Price Pat
Wolfson Molecular Imaging Centre, Academic Department of Radiation Oncology, The University of Manchester, Christie Hospital NHS Trust, Manchester, United Kingdom.
Int J Radiat Oncol Biol Phys. 2006 Oct 1;66(2):331-8. doi: 10.1016/j.ijrobp.2006.04.043. Epub 2006 Jul 12.
To compare the ability of positron emission tomography (PET) to predict response to temozolomide vs. temozolomide plus radiotherapy.
Nineteen patients with high-grade glioma (HGG) were studied. Patients with recurrent glioma received temozolomide 75 mg/m2 daily for 7 weeks (n=8). Newly diagnosed patients received temozolomide 75 mg/m2 daily plus radiotherapy 60 Gy/30 fractions over 6 weeks, followed by six cycles of adjuvant temozolomide 200 mg/m2/day (Days 1-5 q28) starting 1 month after radiotherapy (n=11). [18F]Fluorodeoxyglucose ([18F]FDG) PET scan and magnetic resonance imaging (MRI) were performed at baseline, and 7 and 19 weeks after initiation of temozolomide administration. Changes in glucose metabolic rate (MRGlu) and MRI response were correlated with patient survival.
In the temozolomide-alone group, patients who survived>26 vs. <or=26 weeks showed a greater reduction in MRGlu measured at 7 weeks with median changes of -34% and -4%, respectively (p=0.02). PET responders, defined as a reduction in MRGlu>or=25%, survived longer than nonresponders with mean survival times of 75 weeks (95% CI, 34-115 vs. 20 weeks (95% CI, 14-26) (p=0.0067). In the small group of patients studied, there was no relationship between MRI response and survival (p=0.52). For patients receiving temozolomide plus radiotherapy, there was no difference in survival between PET responders and nonresponders (p=0.32).
Early changes in MRGlu predict response to temozolomide, but not temozolomide plus radiotherapy.
比较正电子发射断层扫描（PET）预测替莫唑胺与替莫唑胺联合放疗疗效的能力。
对19例高级别胶质瘤（HGG）患者进行研究。复发性胶质瘤患者接受替莫唑胺75mg/m²，每日1次，共7周（n = 8）。新诊断患者接受替莫唑胺75mg/m²，每日1次，联合放疗60Gy/30次，共6周，放疗后1个月开始接受6个周期的辅助替莫唑胺治疗，剂量为200mg/m²/天（第1 - 5天，每28天重复）（n = 11）。在基线、替莫唑胺给药开始后7周和19周进行[18F]氟脱氧葡萄糖（[18F]FDG）PET扫描和磁共振成像（MRI）。葡萄糖代谢率（MRGlu）变化和MRI反应与患者生存情况相关。
在单纯替莫唑胺组中，生存时间>26周与≤26周的患者相比，7周时MRGlu降低幅度更大，中位数变化分别为-34%和-4%（p = 0.02）。PET反应者定义为MRGlu降低≥25%，其生存时间长于无反应者，平均生存时间分别为75周（95%CI，34 - 115）和20周（95%CI，14 - 26）（p = 0.0067）。在所研究的小部分患者中，MRI反应与生存之间无相关性（p = 0.52）。对于接受替莫唑胺联合放疗的患者，PET反应者和无反应者的生存情况无差异（p = 0.32）。
MRGlu的早期变化可预测替莫唑胺的疗效，但不能预测替莫唑胺联合放疗的疗效。
