Huang Wei, Fan Min, Liu Bo, Fu Zheng, Zhou Tao, Zhang Zicheng, Gong Heyi, Li Baosheng
Department of Radiation Oncology (Chest Section), Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, China.
Department of Medical Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, China; and.
J Nucl Med. 2014 Oct;55(10):1584-90. doi: 10.2967/jnumed.114.142919. Epub 2014 Sep 11.
The aim of this study was to investigate the value of standardized uptake values (SUVs) and metabolic tumor volume (MTV) in (18)F-FDG PET/CT to predict the survival of patients with locally advanced non-small cell lung cancer during the early stage of concurrent chemoradiotherapy.
A total of 53 patients were included in the prospective study. All patients were evaluated by (18)F-FDG PET before and after 40 Gy of radiotherapy with a concurrent cisplatin-based chemotherapy regimen. Semiquantitative assessment was used to determine the maximum and mean SUVs (SUV(max) and SUV(mean), respectively) and MTV of the primary tumor. The cutoffs for changes in SUV(max), SUV(mean), and MTV (37.2%, 41.7%, and 29.7%, respectively) determined in a previous study were used with Kaplan-Meier curves to separate the groups. The prognostic significance of PET/CT parameters and other clinical variables was assessed using Cox regression analysis.
Overall survival (OS) at 1 and 2 y was 83.0% (46/53) and 52.8% (28/53), respectively. Survival curves for SUV(mean) and MTV were significantly different using the cutoffs. However, Cox regression analysis showed that the only prognostic factor for OS was a decrease in MTV.
The use of repeated (18)F-FDG PET to assess survival early during concurrent chemoradiotherapy is possible in patients with locally advanced non-small cell lung cancer. A decrease in MTV according to (18)F-FDG uptake by the primary tumor correlates with higher long-term OS.
本研究旨在探讨标准化摄取值（SUV）和代谢肿瘤体积（MTV）在18F-FDG PET/CT中预测局部晚期非小细胞肺癌患者同步放化疗早期生存率的价值。
本前瞻性研究共纳入53例患者。所有患者在接受40 Gy放疗并同时采用基于顺铂的化疗方案前后均接受18F-FDG PET评估。采用半定量评估法确定原发肿瘤的最大SUV和平均SUV（分别为SUV(max)和SUV(mean)）以及MTV。使用先前研究中确定的SUV(max)、SUV(mean)和MTV变化的截断值（分别为37.2%、41.7%和29.7%），通过Kaplan-Meier曲线对组进行划分。使用Cox回归分析评估PET/CT参数和其他临床变量的预后意义。
1年和2年的总生存率（OS）分别为83.0%（46/53）和52.8%（28/53）。使用截断值时，SUV(mean)和MTV的生存曲线有显著差异。然而，Cox回归分析表明，OS的唯一预后因素是MTV的降低。
对于局部晚期非小细胞肺癌患者，在同步放化疗早期使用重复的18F-FDG PET评估生存率是可行的。原发肿瘤摄取18F-FDG后MTV的降低与较高的长期OS相关。
