Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jiyan Road 440, 250117 Jinan, Shandong, China.
J Cancer Res Clin Oncol. 2010 Jun;136(6):883-9. doi: 10.1007/s00432-009-0729-7. Epub 2009 Nov 20.
The purpose of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) and metabolic index (MI) from fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in patients with nasopharyngeal carcinoma (NPC).
From October 2002 to July 2004, 41 patients with NPC who underwent (18)F-FDG PET-CT scan before and after radiotherapy were reviewed retrospectively. All patients received intensity-modulated radiotherapy using 6MV X-rays. We examined the association of MTV and the results of long-term follow-up of the patients.
Patients having tumors with an MTV below 30 cm(3) had significantly better 5-year overall survival (OS) (84.6:46.7%, P = 0.006) and disease-free survival (DFS) (73.1:40.0%, P = 0.014) than patients with an MTV of 30 cm(3) or greater. And the patients with MI below 130 had significantly higher 5-year OS (88.0:43.8%, P = 0.002) and DFS (76.0:37.5%, P = 0.005) than other patients. In the Cox multivariate analysis, MI and metabolic response (MR) were predictive of DFS, and we did not find a significant relationship between standard uptake value (SUV) and OS or DFS.
The present study shows that tumor volume parameters, especially the combination of MTV and SUV in the "metabolic index", are valuable for predicting long-term survival. High MI may be useful for identifying patients requiring more aggressive treatment.
本研究旨在评估氟-18-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）中代谢肿瘤体积（MTV）和代谢指数（MI）对鼻咽癌（NPC）患者的预后价值。
回顾性分析 2002 年 10 月至 2004 年 7 月间 41 例 NPC 患者放疗前后 18F-FDG PET/CT 扫描资料。所有患者均接受 6MV X 射线强度调制放疗。我们研究了 MTV 与患者长期随访结果的相关性。
肿瘤 MTV 低于 30 cm3 的患者 5 年总生存率（OS）（84.6：46.7%，P = 0.006）和无病生存率（DFS）（73.1：40.0%，P = 0.014）显著高于 MTV 为 30 cm3 或更大的患者。MI 低于 130 的患者 5 年 OS（88.0：43.8%，P = 0.002）和 DFS（76.0：37.5%，P = 0.005）显著高于其他患者。在 Cox 多因素分析中，MI 和代谢反应（MR）是 DFS 的预测因素，我们未发现 SUV 与 OS 或 DFS 之间存在显著关系。
本研究表明，肿瘤体积参数，尤其是 MTV 和“代谢指数”中的 SUV 的结合，对预测长期生存具有重要价值。高 MI 可能有助于识别需要更积极治疗的患者。
