Suchorska Bogdana, Jansen Nathalie L, Linn Jennifer, Kretzschmar Hans, Janssen Hendrik, Eigenbrod Sabina, Simon Matthias, Pöpperl Gabriele, Kreth Friedrich W, la Fougere Christian, Weller Michael, Tonn Joerg C
From the Departments of Neurosurgery (B.S., F.W.K., J.C.T.), Nuclear Medicine (N.L.J.), Neuroradiology (J.L., H.J.), and Neuropathology (H.K., S.E.), Ludwig-Maximilians University Munich; Department of Neurosurgery (M.S.), University of Bonn; Department of Nuclear Medicine (G.P.), Katharinenhospital Stuttgart; Department of Nuclear Medicine (C.l.F.), University of Tuebingen, Germany; and Department of Neurology (M.W.), University Hospital Zurich, Switzerland.
Neurology. 2015 Feb 17;84(7):710-9. doi: 10.1212/WNL.0000000000001262. Epub 2015 Jan 21.
The aim of this prospective longitudinal study was to identify static and dynamic O-(2-[(18)F]fluoroethyl)-L-tyrosine PET ((18)FET-PET)-derived imaging biomarkers in patients with glioblastoma (GBM).
Seventy-nine patients with newly diagnosed GBM were included; 42 patients underwent stereotactic biopsy (unresectable tumors) and 37 patients microsurgical tumor resection. All patients were scheduled to receive radiotherapy plus concomitant and adjuvant temozolomide (RCx/TMZ). (18)FET-PET evaluation using static and dynamic analysis was done before biopsy/resection, after resection, 4 to 6 weeks following RCx, and after 3 cycles of TMZ. Endpoints were survival and progression-free-survival. Prognostic factors were obtained from proportional hazards models.
Biological tumor volume before RCx (BTV(preRCx)) was the most important (18)FET-PET-derived imaging biomarker and was independent of MGMT promoter methylation and clinical prognostic factors: patients with smaller BTV(preRCx) had significantly longer progression-free and overall survival (OS). (18)FET time-activity curves (TACs) before treatment and their changes after RCx were also related to outcome; patients with initially increasing TACs experienced longer OS.
BTV(preRCx) and TAC represent important (18)FET-PET-derived imaging biomarkers in GBM. Increasing TACs are associated with prolonged OS. The BTV(preRCx) is a strong prognostic factor for progression-free survival and OS independent of the mode of surgery. Our data furthermore suggest that patients harboring resectable GBM might benefit from maximal PET-guided tumor resection.
这项前瞻性纵向研究的目的是在胶质母细胞瘤（GBM）患者中识别静态和动态O-（2-[(18)F]氟乙基）-L-酪氨酸PET（(18)FET-PET）衍生的成像生物标志物。
纳入79例新诊断的GBM患者；42例患者接受立体定向活检（不可切除肿瘤），37例患者接受显微手术肿瘤切除。所有患者计划接受放疗加同步和辅助替莫唑胺（RCx/TMZ）治疗。在活检/切除前、切除后、RCx后4至6周以及TMZ 3个周期后，使用静态和动态分析进行(18)FET-PET评估。终点指标为生存率和无进展生存期。从比例风险模型中获得预后因素。
RCx前的生物肿瘤体积（BTV(preRCx)）是最重要的(18)FET-PET衍生成像生物标志物，且独立于MGMT启动子甲基化和临床预后因素：BTV(preRCx)较小的患者无进展生存期和总生存期（OS）显著更长。治疗前的(18)FET时间-活性曲线（TAC）及其RCx后的变化也与预后相关；初始TAC上升的患者OS更长。
BTV(preRCx)和TAC是GBM中重要的(18)FET-PET衍生成像生物标志物。TAC上升与OS延长相关。BTV(preRCx)是无进展生存期和OS的强有力预后因素，与手术方式无关。我们的数据还表明，患有可切除GBM的患者可能从最大程度的PET引导下肿瘤切除中获益。
