Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
Liver Int. 2011 Sep;31(8):1144-9. doi: 10.1111/j.1478-3231.2011.02541.x. Epub 2011 May 3.
Sorafenib (Nexavar) is an orally active multikinase inhibitor that is approved for the treatment of hepatocellular carcinoma (HCC). In this study, we used (18) F-2-fluoro-2-deoxyglucose ((18) F-FDG) with positron emission tomography (PET) to predict the treatment outcome of sorafenib in patients with advanced HCC.
A total of 29 patients with HCC were included. Baseline (18) F-FDG PET scans were performed a median of 14 days before sorafenib treatment. Sorafenib was administered orally at a dose of 400 mg twice daily. For statistical analysis, the standardized uptake value (SUV) of the most hypermetabolic lesion was obtained and assigned as the SUVmax for each patient.
Among 29 patients, one patient achieved partial remission and 14 patients showed stable disease. The overall survival (OS) and progression free survival (PFS) were 5.1 months [95% confidence interval (CI): 0.0-12.0] and 3.8 months (95% CI: 1.4-6.2). The multivariate analysis of OS showed that four indices, Eastern Cooperative Oncology Group performance status, α-fetoprotein (AFP) concentration, portal vein thrombosis and SUVmax were significant prognostic factors (P=0.030, P=0.024, P=0.020 and P=0.015 respectively). AFP concentration and SUVmax were independent prognostic factors for PFS, too (P=0.003 and P=0.026 respectively). When the patients were divided into two groups: low SUVmax (n=10; <5.00) and high SUVmax (n=19;≥ 5.00), the low SUV group showed significantly longer OS and PFS (P=0.023 and P=0.042 respectively).
Our study showed that the degree of FDG uptake is an independent prognostic factor in patients with HCC who undergo sorafenib treatment.
索拉非尼（Nexavar）是一种口服活性多激酶抑制剂，已被批准用于治疗肝细胞癌（HCC）。在这项研究中，我们使用正电子发射断层扫描（PET）中的（18）F-2-氟-2-脱氧葡萄糖（（18）F-FDG）来预测晚期 HCC 患者接受索拉非尼治疗的疗效。
共纳入 29 例 HCC 患者。在开始索拉非尼治疗前中位数为 14 天进行基线（18）F-FDG PET 扫描。索拉非尼口服给药，剂量为 400mg，每日两次。为了进行统计分析，获得了最代谢亢进病变的标准化摄取值（SUV），并将其分配给每位患者的 SUVmax。
在 29 例患者中，1 例患者达到部分缓解，14 例患者疾病稳定。总生存期（OS）和无进展生存期（PFS）分别为 5.1 个月（95%CI：0.0-12.0）和 3.8 个月（95%CI：1.4-6.2）。OS 的多变量分析显示，4 个指标，东部合作肿瘤学组表现状态、甲胎蛋白（AFP）浓度、门静脉血栓形成和 SUVmax 是显著的预后因素（P=0.030、P=0.024、P=0.020 和 P=0.015）。AFP 浓度和 SUVmax 也是 PFS 的独立预后因素（P=0.003 和 P=0.026）。当患者分为两组：低 SUVmax 组（n=10；<5.00）和高 SUVmax 组（n=19；≥5.00）时，低 SUVmax 组的 OS 和 PFS 明显延长（P=0.023 和 P=0.042）。
我们的研究表明，在接受索拉非尼治疗的 HCC 患者中，FDG 摄取程度是一个独立的预后因素。
