Department of Radiation Oncology, Stanford University, CA.
Department of Radiation Oncology, David Geffen School of Medicine at UCLA, CA.
Clin Lung Cancer. 2012 Jan;13(1):52-58. doi: 10.1016/j.cllc.2011.05.001. Epub 2011 Jun 24.
Fluorine-18 flurodeoxyglucose positron emission tomography (FDG-PET) imaging has rapidly become the standard of care for staging patients with lung cancer. We evaluated the prognostic value of metabolic tumor volume (MTV), a measure of tumor burden on FDG-PET imaging, in patients with non-small-cell lung cancer (NSCLC) treated definitively.
A retrospective review identified 61 patients with NSCLC who underwent FDG-PET imaging for pretreatment staging. Metabolically active tumor regions were segmented on the PET scans semiautomatically to calculate the total body MTV. We determined the relationship of overall survival (OS) and progression-free survival (PFS) with MTV in the entire cohort, and in the subgroup treated definitively.
The estimated median PFS and OS for the entire cohort were 11.1 months and 18.9 months. Higher MTV was significantly associated with worse OS (P = 0.00075) and PFS (P = 0.00077). For definitively treated patients, when MTV was analyzed as a binary value above or below the median value, 2-year PFS was 60% versus 39.7% (median PFS 34.9 vs. 11.9 months) and 2-year OS was 79.7% versus 33.3% (median OS 41.9 vs. 18.9 months), respectively (log-rank P = 0.12 for PFS and P = 0.066 for OS). When MTV was analyzed as a continuous variable, multivariate Cox proportional hazards analysis demonstrated a trend to worse PFS (hazard ratio [HR] = 1.31; P = 0.12) and significantly worse OS (HR = 1.53; P = 0.018) with increasing MTV after controlling for known prognostic variables.
Tumor burden as assessed by MTV yields prognostic information on survival beyond that of established prognostic factors in patients with NSCLC treated definitively.
氟-18 氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）成像已迅速成为肺癌分期患者的标准治疗方法。我们评估了代谢肿瘤体积（MTV）在接受确定性治疗的非小细胞肺癌（NSCLC）患者中的预后价值，MTV 是 FDG-PET 成像上肿瘤负担的衡量指标。
回顾性分析确定了 61 例接受 FDG-PET 成像进行治疗前分期的 NSCLC 患者。在 PET 扫描上半自动化地分割代谢活跃的肿瘤区域以计算全身 MTV。我们确定了整个队列和确定性治疗亚组中 MTV 与总生存（OS）和无进展生存（PFS）的关系。
整个队列的中位 PFS 和 OS 估计值分别为 11.1 个月和 18.9 个月。较高的 MTV 与较差的 OS（P = 0.00075）和 PFS（P = 0.00077）显著相关。对于确定性治疗的患者，当 MTV 分析为高于或低于中位数的二进制值时，2 年 PFS 分别为 60%和 39.7%（中位 PFS 分别为 34.9 和 11.9 个月），2 年 OS 分别为 79.7%和 33.3%（中位 OS 分别为 41.9 和 18.9 个月），（对数秩 P = 0.12 用于 PFS 和 P = 0.066 用于 OS）。当 MTV 作为连续变量进行分析时，多变量 Cox 比例风险分析表明，在控制已知预后变量后，MTV 增加与 PFS 较差（风险比 [HR] = 1.31；P = 0.12）和 OS 显著较差（HR = 1.53；P = 0.018）相关。
在接受确定性治疗的 NSCLC 患者中，MTV 评估的肿瘤负担提供了生存预后信息，超过了既定预后因素。
