Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Cancer. 2013 Mar 15;119(6):1195-202. doi: 10.1002/cncr.27855. Epub 2012 Dec 4.
This study was undertaken to evaluate the prognostic value of quantitative metabolic parameters in [(18) F]2-fluoro-2-deoxyglucose (FDG)-positron emission tomography (PET) for diffuse large B cell lymphoma (DLBCL).
A total of 140 DLBCL patients underwent FDG-PET scans before rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy. The maximal standardized uptake value (SUVmax ) and total lesion glycolysis (TLG) were calculated, with the margin thresholds as 25%, 50%, and 75% of SUVmax of all lesions. Treatment outcomes were compared between groups according to metabolic parameters and the International Prognostic Index (IPI).
After a median follow-up of 28.5 months (range, 5-81 months), the 2-year progression-free survival (PFS) and overall survival (OS) were 83% and 87%, respectively. Among metabolic parameters, TLG at the threshold of 50% (TLG50 ) was significantly associated with treatment outcomes. High TLG50 values (>415.5) were associated with reduced survivals compared with low TLG50 values (≤415.5) (2-year PFS of 73% versus 92%, P = .007; and 2-year OS of 81% versus 93%, P = .031). High IPI score (≥3) significantly reduced OS (2-year OS of 79% versus 90%, P = .049). Ann Arbor stage III/IV adversely affected PFS (P = .013). However, high IPI score and Ann Arbor stage of III/V did not significantly shorten PFS (P = .200) and OS (P = .921), respectively. High TLG50 values independently predicted survivals by multivariate analysis (hazard ratio = 4.4; 95% confidence interval = 1.5-13.1; P = .008 for PFS and hazard ratio = 3.1; 95% confidence interval = 1.0-9.6; P = .049 for OS).
Combined assessment of volume and metabolism (ie, TLG) is predictive of survivals in DLBCL patients who are treated with R-CHOP. Cancer 2013. © 2012 American Cancer Society.
本研究旨在评估定量代谢参数在氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在弥漫性大 B 细胞淋巴瘤（DLBCL）中的预后价值。
共 140 例 DLBCL 患者在利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）化疗前进行 FDG-PET 扫描。计算最大标准化摄取值（SUVmax）和总病灶糖酵解（TLG），病变 SUVmax 的边缘阈值分别为 25%、50%和 75%。根据代谢参数和国际预后指数（IPI）将治疗结果与各组进行比较。
中位随访 28.5 个月（范围 5-81 个月）后，2 年无进展生存率（PFS）和总生存率（OS）分别为 83%和 87%。在代谢参数中，阈值为 50%的 TLG（TLG50）与治疗结果显著相关。与 TLG50 值较低（≤415.5）相比，TLG50 值较高（>415.5）与生存率降低相关（2 年 PFS 分别为 73%和 92%，P=0.007；2 年 OS 分别为 81%和 93%，P=0.031）。高 IPI 评分（≥3）显著降低 OS（2 年 OS 分别为 79%和 90%，P=0.049）。Ann Arbor 分期 III/IV 期不良影响 PFS（P=0.013）。然而，高 IPI 评分和 Ann Arbor 分期 III/V 期并未显著缩短 PFS（P=0.200）和 OS（P=0.921）。多因素分析显示，高 TLG50 值独立预测生存率（危险比=4.4；95%置信区间=1.5-13.1；P=0.008 用于 PFS 和危险比=3.1；95%置信区间=1.0-9.6；P=0.049 用于 OS）。
在接受 R-CHOP 治疗的 DLBCL 患者中，联合评估体积和代谢（即 TLG）可预测生存情况。癌症 2013。©2012 年美国癌症协会。
