Department of Radiation Oncology, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Lung Cancer. 2012 Dec;78(3):219-24. doi: 10.1016/j.lungcan.2012.08.016. Epub 2012 Sep 23.
To test whether (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) imaging metrics correlate with outcomes in patients with stage I non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR).
Fifty-four patients with stage I NSCLC underwent pre-SABR PET at simulation and/or post-SABR PET within 6 months. We analyzed maximum standardized uptake value (SUV(max)) and metabolic tumor volume defined using several thresholds (MTV50%, or MTV2, 4, 7, and 10). Endpoints included primary tumor control (PTC), progression-free survival (PFS), overall survival (OS) and cancer-specific survival (CSS). We performed Kaplan-Meier, competing risk, and Cox proportional hazards survival analyses.
Patients received 25-60 Gy in 1 to 5 fractions. Median follow-up time was 13.2 months. The 1-year estimated PTC, PFS, OS and CSS were 100, 83, 87 and 94%, respectively. Pre-treatment SUV(max) (p=0.014), MTV(7) (p=0.0077), and MTV(10) (p=0.0039) correlated significantly with OS. In the low-MTV(7)vs. high-MTV(7) sub-groups, 1-year estimated OS was 100 vs. 78% (p=0.0077) and CSS was 100 vs. 88% (p=0.082).
In this hypothesis-generating study we identified multiple pre-treatment PET-CT metrics as potential predictors of OS and CSS in patients with NSCLC treated with SABR. These could aid risk-stratification and treatment individualization if validated prospectively.
检测 18 氟-脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET-CT）的影像学指标是否与接受立体定向消融放疗（SABR）的 I 期非小细胞肺癌（NSCLC）患者的结局相关。
54 例 I 期 NSCLC 患者在模拟定位时和/或 SABR 后 6 个月内行 PET-CT 检查。我们分析了最大标准化摄取值（SUV(max)）和使用多个阈值（MTV50%，或 MTV2、4、7 和 10）定义的代谢肿瘤体积（MTV）。终点包括原发肿瘤控制（PTC）、无进展生存（PFS）、总生存（OS）和癌症特异性生存（CSS）。我们进行了 Kaplan-Meier、竞争风险和 Cox 比例风险生存分析。
患者接受 1 至 5 个分割的 25-60Gy 照射。中位随访时间为 13.2 个月。1 年估计的 PTC、PFS、OS 和 CSS 分别为 100%、83%、87%和 94%。治疗前 SUV(max)（p=0.014）、MTV(7)（p=0.0077）和 MTV(10)（p=0.0039）与 OS 显著相关。在低 MTV(7)与高 MTV(7)亚组中，1 年估计的 OS 分别为 100%和 78%（p=0.0077），CSS 分别为 100%和 88%（p=0.082）。
在这项假设生成性研究中，我们发现多个治疗前 PET-CT 指标可能是接受 SABR 治疗的 NSCLC 患者 OS 和 CSS 的潜在预测因素。如果前瞻性验证，这些指标可能有助于风险分层和治疗个体化。
