Department of Nuclear Medicine, University Hospital Virgen de las Nieves, Granada, Spain.
J Surg Oncol. 2010 May 1;101(6):486-94. doi: 10.1002/jso.21525.
Neoadjuvant therapy response assessment is crucial in patients with non-small cell lung cancer (NSCLC). FDG-PET has emerged as a valuable tool for defining therapy response assessment in other tumours.
To systematically review publications appearing in the literature describing induction therapy response assessment with FDG-PET in NSCLC.
We performed a bibliographic search and selected only prospective studies in order to include the highest levels of evidence.
Nine of 497 potentially relevant publications were selected. The ranges of sensitivity, specificity, positive predictive value and negative predictive value for primary tumour response assessment were 80-100%, 0-100%, 42.9-100%, and 66.7-100%, respectively. Pooling data for N2 restaging after neoadjuvant response the overall sensitivity was 63.8% (95% CI, 53.3-73.7%) and overall specificity was 85.3% (95% CI, 80.4-89.4%).
The results of the analysis do not support the use of FDG-PET as the only re-assessment tool for mediastinal lymph node evaluation for routine clinical use. FDG-PET seems to predict primary tumour response to induction therapy but it could not be shown by pooling analysis.
新辅助治疗反应评估在非小细胞肺癌（NSCLC）患者中至关重要。FDG-PET 已成为评估其他肿瘤治疗反应的一种有价值的工具。
系统回顾文献中描述 FDG-PET 评估 NSCLC 诱导治疗反应的出版物。
我们进行了文献检索，仅选择了前瞻性研究，以纳入最高水平的证据。
在 497 篇潜在相关文献中，有 9 篇被选中。原发肿瘤反应评估的灵敏度、特异性、阳性预测值和阴性预测值范围分别为 80-100%、0-100%、42.9-100%和 66.7-100%。对新辅助治疗反应后 N2 重新分期的数据进行汇总，总体灵敏度为 63.8%（95%CI，53.3-73.7%），总体特异性为 85.3%（95%CI，80.4-89.4%）。
分析结果不支持将 FDG-PET 作为纵隔淋巴结评估的唯一重新评估工具常规用于临床。FDG-PET 似乎可以预测诱导治疗对原发肿瘤的反应，但通过汇总分析无法证明这一点。
