治疗前代谢肿瘤体积预测接受确定性放化疗的不可切除局部晚期食管鳞状细胞癌的短期预后。

Pretreatment metabolic tumor volumes to predict the short-term outcome of unresectable locally advanced squamous cell carcinoma of the esophagus treated with definitive chemoradiotherapy.

作者信息

Chen Shang-Wen, Hsieh Te-Chun, Ding Hueisch-Jy, Yen Kuo-Yang, Lin Chen-Yuan, Liang Ji-An, Kao Chia-Hung

机构信息

aDepartment of Radiation Oncology bGraduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine cDepartment of Nuclear Medicine and PET Center dDepartment of Biomedical Imaging and Radiological Science eDivision of Hematology and Oncology, China Medical University Hospital, Taichung fSchool of Medicine, Taipei Medical University, Taipei gDepartment of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan.

出版信息

Nucl Med Commun. 2014 Mar;35(3):291-7. doi: 10.1097/MNM.0000000000000046.

DOI:10.1097/MNM.0000000000000046

PMID:24276528

Abstract

PURPOSE

The aim of the study was to investigate the predictive role of pretreatment metabolic tumor volume (MTV) in patients with squamous cell carcinoma of locally advanced esophageal cancer treated with definitive chemoradiotherapy.

PATIENTS AND METHODS

Ninety patients received pretreatment with (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT, and two types of MTVs were measured on the basis of either a maximal standardized uptake value (SUVmax) of 2.5 (MTV2.5) or a fixed threshold of 20% (MTV20%). Overall survival (OS) and disease-free survival (DFS) were examined, and independent prognosticators were identified by Cox regression analysis.

RESULTS

On a median follow-up of 15 months, 51 patients were seen to have died because of tumor recurrence or other illnesses. Multivariate analysis of OS revealed that MTV20%>40 ml was the only predictor of outcome with a lower 1-year OS [P=0.003, hazard ratio (HR)=2.29, 95% confidence interval (CI) 1.36-3.91]. Two independent predictors of DFS were MTV20%>40 ml (P=0.02, HR=1.78, 95% CI 1.09-2.91) and stage IV disease (P=0.01, HR=1.84, 95% CI 1.12-3.03).

CONCLUSION

Pretreatment MTV20% is a novel marker for OS and DFS in patients with unresectable locally advanced esophageal cancer treated with definitive chemoradiotherapy. Treatment intensification must be considered for patients with higher MTVs.

摘要

目的

本研究旨在探讨治疗前代谢肿瘤体积（MTV）在接受根治性放化疗的局部晚期食管癌鳞状细胞癌患者中的预测作用。

患者与方法

90例患者接受了治疗前的（18）F-氟脱氧葡萄糖（（18）F-FDG）PET/CT检查，并基于最大标准化摄取值（SUVmax）为2.5（MTV2.5）或固定阈值20%（MTV20%）测量了两种类型的MTV。检查总生存期（OS）和无病生存期（DFS），并通过Cox回归分析确定独立预后因素。

结果

中位随访15个月时，51例患者因肿瘤复发或其他疾病死亡。OS的多因素分析显示，MTV20% > 40 ml是1年OS较低的唯一预后因素[P = 0.003，风险比（HR）= 2.29，95%置信区间（CI）1.36 - 3.91]。DFS的两个独立预后因素为MTV20% > 40 ml（P = 0.02，HR = 1.78，95% CI 1.09 - 2.91）和IV期疾病（P = 0.01，HR = 1.84，95% CI 1.12 - 3.03）。