放化疗后正电子发射断层扫描标准化摄取值的下降幅度越大，胃食管腺癌患者的生存率越高。

The higher the decrease in the standardized uptake value of positron emission tomography after chemoradiation, the better the survival of patients with gastroesophageal adenocarcinoma.

作者信息

Javeri Heta, Xiao Lianchun, Rohren Eric, Lee Jeffrey H, Liao Zhongxing, Hofstetter Wayne, Maru Dipen, Bhutani Manoop S, Swisher Stephen G, Macapinlac Homer, Wang Xuemei, Ajani Jaffer A

机构信息

Department of Medical Oncology, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Cancer. 2009 Nov 15;115(22):5184-92. doi: 10.1002/cncr.24604.

DOI:10.1002/cncr.24604

PMID:19685531

Abstract

BACKGROUND

Postchemoradiation percentage decrease in standardized uptake value (SUV) of positron emission tomography (PET) from baseline correlates with overall survival (OS) and pathologic response. Analyses of dichotomized data are commonly reported. The authors analyzed percentage SUV decrease as both dichotomized and continuous variables.

METHODS

The authors assessed 151 consecutive patients with gastroesophageal adenocarcinoma who had chemoradiation and surgery. Baseline and postchemoradiation PET/computed tomography imaging was performed. The log-rank test and Cox proportional hazards models were used to associate percentage SUV changes and OS, and logistic regression models were used to detect the association between percentage SUV changes and pathologic response.

RESULTS

A >52% SUV decrease (dichotomized analysis) was associated with a longer OS (log-rank test, P = .023). The univariate Cox proportional hazards model indicated that greater percentage SUV decrease (as a continuous variable) was associated with a lower risk of death (hazard ratio [HR], 0.99; P = .01). Pathologic response (< or =50% residual cancer) was associated with longer OS (P = .003). Patients with chemoradiation resistance (>50% residual cancer) tended to have a higher risk of death than those with chemoradiation sensitivity (0-50% residual cancer; HR, 2.12; P = .099). In the multivariate model, the percentage SUV decrease (as a continuous variable) was the only prognosticator of OS (P = .01). The percentage SUV decrease was nonsignificantly associated with pathologic complete response (univariate odds ratio [OR], 1.01; P = .06 and multivariate OR, 1.03; P = .07).

CONCLUSIONS

The greater the decline in SUV after chemoradiation, the longer is the OS of gastroesophageal adenocarcinoma patients. The percentage SUV decrease as a continuous variable is a better prognosticator of OS than its dichotomized assessments.

摘要

背景

正电子发射断层扫描（PET）标准化摄取值（SUV）从基线起的放化疗后下降百分比与总生存期（OS）及病理反应相关。二分数据的分析较为常见。作者将SUV下降百分比作为二分变量和连续变量进行了分析。

方法

作者评估了151例连续接受放化疗及手术的胃食管腺癌患者。进行了基线及放化疗后的PET/计算机断层扫描成像。采用对数秩检验和Cox比例风险模型来关联SUV变化百分比与OS，采用逻辑回归模型来检测SUV变化百分比与病理反应之间的关联。

结果

SUV下降>52%（二分分析）与更长的OS相关（对数秩检验，P = 0.023）。单变量Cox比例风险模型表明，更大的SUV下降百分比（作为连续变量）与更低的死亡风险相关（风险比[HR]，0.99；P = 0.01）。病理反应（残余癌≤50%）与更长的OS相关（P = 0.003）。放化疗抵抗（残余癌>50%）的患者比放化疗敏感（残余癌0 - 50%）的患者有更高的死亡风险倾向（HR，2.12；P = 0.099）。在多变量模型中，SUV下降百分比（作为连续变量）是OS的唯一预后因素（P = 0.01）。SUV下降百分比与病理完全缓解无显著关联（单变量优势比[OR]，1.01；P = 0.06，多变量OR，1.03；P = 0.07）。