PET Center, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstrasse 400, 01328, Dresden, Germany,
Eur J Nucl Med Mol Imaging. 2015 Mar;42(3):429-37. doi: 10.1007/s00259-014-2953-x. Epub 2014 Nov 22.
In a previous study, we demonstrated the first evidence that the asphericity (ASP) of pretherapeutic FDG uptake in the primary tumor provides independent prognostic information in patients with head and neck cancer. The aim of this work was to confirm these results in an independent patient group examined at a different site.
FDG-PET/CT was performed in 37 patients. The primary tumor was delineated by an automatic algorithm based on adaptive thresholding. For the resulting ROIs, the metabolically active part of the tumor (MTV), SUVmax, SUVmean, total lesion glycolysis (TLG) and ASP were computed. Univariate Cox regression with respect to progression free survival (PFS) and overall survival (OS) was performed. For survival analysis, patients were divided in groups of high and low risk according to the parameter cut-offs defined in our previous work. In a second step, the cut-offs were adjusted to the present data. Univariate and multivariate Cox regression was performed for the pooled data consisting of the current and the previously described patient group (N = 68). In multivariate Cox regression, clinically relevant parameters were included.
Univariate Cox regression using the previously published cut-off values revealed TLG (hazard ratio (HR) = 3) and ASP (HR = 3) as significant predictors for PFS. For OS MTV (HR = 2.7) and ASP (HR = 5.9) were significant predictors. Using the adjusted cutoffs MTV (HR = 2.9/3.3), TLG (HR = 3.1/3.3) and ASP (HR = 3.1/5.9) were prognostic for PFS/OS. In the pooled data, multivariate Cox regression revealed a significant prognostic value with respect to PFS/OS for MTV (HR = 2.3/2.1), SUVmax (HR = 2.1/2.5), TLG (HR = 3.5/3.6), and ASP (HR = 3.4/4.4).
Our results confirm the independent prognostic value of ASP of the pretherapeutic FDG uptake in the primary tumor in patients with head and neck cancer. Moreover, these results demonstrate that ASP can be determined unambiguously across different sites.
在之前的研究中，我们首次证明了原发肿瘤治疗前 FDG 摄取的非球性（ASP）在头颈部癌症患者中提供独立的预后信息。本研究的目的是在不同部位检查的另一组患者中证实这些结果。
对 37 例患者进行 FDG-PET/CT 检查。采用基于自适应阈值的自动算法对原发肿瘤进行勾画。对于得到的 ROI，计算肿瘤代谢活跃部分（MTV）、SUVmax、SUVmean、总病变糖酵解（TLG）和 ASP。用单因素 Cox 回归分析与无进展生存（PFS）和总生存（OS）相关的因素。为了生存分析，根据我们之前工作中定义的参数临界值将患者分为高危和低危组。在第二步中，根据目前的数据对临界值进行调整。将当前数据和之前描述的患者组（N=68）的数据合并，进行单因素和多因素 Cox 回归分析。在多因素 Cox 回归中，纳入了临床相关的参数。
使用之前发表的临界值进行单因素 Cox 回归分析显示 TLG（危险比（HR）=3）和 ASP（HR=3）是 PFS 的显著预测因子。对于 OS，MTV（HR=2.7）和 ASP（HR=5.9）是显著的预测因子。使用调整后的临界值 MTV（HR=2.9/3.3）、TLG（HR=3.1/3.3）和 ASP（HR=3.1/5.9）是 PFS/OS 的预后因素。在合并数据中，多因素 Cox 回归分析显示 MTV（HR=2.3/2.1）、SUVmax（HR=2.1/2.5）、TLG（HR=3.5/3.6）和 ASP（HR=3.4/4.4）与 PFS/OS 有显著的预后价值。
我们的结果证实了原发肿瘤治疗前 FDG 摄取的 ASP 在头颈部癌症患者中具有独立的预后价值。此外，这些结果表明，ASP 可以在不同部位明确确定。
Zotero 插件