Onitilo Adedayo A, Engel Jessica M, Demos Jennifer M, Mukesh Bickol
Department of Hematology/Oncology, Marshfield Clinic - Weston Center, 3501 Cranberry Boulevard, Weston, Wisconsin 54476, USA.
Clin Med Res. 2008 Sep;6(2):72-7. doi: 10.3121/cmr.2008.797. Epub 2008 Sep 18.
Small cell lung cancer (SCLC) represents 15% to 25% of lung cancers. Despite favorable initial treatment response rates, recurrence is likely and long-term prognosis dismal. Accurate measurement of therapy response is critical to determine which patients might be spared additional treatment, and potential side effects. (18)F-fluorodeoxyglucose positron emission tomography (PET) may help distinguish necrotic or fibrous tissue from residual cancer, thus informing further treatment and prognosis. DESIGN/SETTING/PARTICIPANTS AND METHODS: Retrospective chart review study of limited stage SCLC patients with PET scanning within 4 months post-chemotherapy at Marshfield Clinic, Marshfield, Wisconsin. Diagnosis of SCLC occurred from December 1, 2001 through December 31, 2007.
Twenty-two patients (approximately 7%) had post-treatment PET: 11 positive, 11 negative. Median duration from last chemotherapy to PET was 36 days (range, 3 to 125 days). Median follow-up for all patients was 34.4 months (range, 6.8 to 65.9 months). Estimated median progression-free survival for all patients was 8.1 months (95% confidence intervals [CI], 4.3 to 11.9 months), 10.5 months for PET negative (95% CI, 8.1 to >57.8 months) and 4.3 months for PET positive patients (95% CI, 2.8 to >7.2 months) (P<0.007, log-rank test). Median survival for all patients was 19.2 months (95% CI, 10.3 to >65.8 months). Estimated median survival for PET negative patients was longer than PET positive (29.2 versus 10.3 months, P=0.10).
Post-treatment PET, prognostically significant, may be underutilized.
小细胞肺癌（SCLC）占肺癌的15%至25%。尽管初始治疗缓解率良好，但复发很可能发生，且长期预后不佳。准确测量治疗反应对于确定哪些患者可以避免额外治疗及其潜在副作用至关重要。（18）F-氟脱氧葡萄糖正电子发射断层扫描（PET）可能有助于区分坏死或纤维组织与残留癌，从而为进一步治疗和预后提供依据。设计/背景/参与者及方法：对威斯康星州马什菲尔德市马什菲尔德诊所化疗后4个月内接受PET扫描的局限期SCLC患者进行回顾性病历审查研究。SCLC的诊断时间为2001年12月1日至2007年12月31日。
22例患者（约7%）接受了治疗后PET检查：11例阳性，11例阴性。从最后一次化疗到PET检查的中位时间为36天（范围3至125天）。所有患者的中位随访时间为34.4个月（范围6.8至65.9个月）。所有患者的估计无进展生存期为8.1个月（95%置信区间[CI]，4.3至11.9个月），PET阴性患者为10.5个月（95%CI，8.1至>57.8个月），PET阳性患者为4.3个月（95%CI，2.8至>7.2个月）（P<0.007，对数秩检验）。所有患者的中位生存期为19.2个月（95%CI，10.3至>65.8个月）。PET阴性患者的估计中位生存期长于PET阳性患者（29.2对10.3个月，P = 0.10）。
治疗后PET具有预后意义，可能未得到充分利用。
