Ozeki Naoki, Kawaguchi Koji, Fukui Takayuki, Fukumoto Koichi, Nakamura Shota, Okasaka Toshiki, Yokoi Kohei
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2015 Aug;77(3):475-80.
This study was designed to elucidate the predictive usefulness of the response evaluation criteria in solid tumors (RECIST), a volume response (VR; a > 50% reduction in the tumor volume) and the post-neoadjuvant therapy maximum standardized uptake value (post-SUVmax) in patients with non-small cell lung cancer (NSCLC) after neoadjuvant therapy. Between December 2006 and June 2012, 33 patients with clinical stage II and III NSCLC who underwent pulmonary resection following neoadjuvant therapy were enrolled. The relationships between the variables and a pathological complete response (pCR), the disease-free survival (DFS) and the overall survival (OS) were analyzed. As neoadjuvant therapy, 24 patients received chemoradiotherapy, five patients received chemotherapy and four patients were given radiation therapy. Based on the RECIST, 12 tumors were classified as having a partial response and 21 tumors were classified as stable disease. Twenty-one tumors showed a VR and 12 did not. Twenty-five tumors had a post-SUVmax ≤7.5 and eight had a post-SUVmax >7.5. Eight tumors had a pCR. In the multivariate Cox regression analysis, both a non-VR and a post-SUVmax >7.5 were significant variables predicting the DFS (p = 0.0422 and 0.0127, respectively), but either was not for OS. The post-SUVmax was also a significant variable for the pCR rate (p = 0.0067). The post-treatment SUVmax can be a valid alternative variable that can be used to predict the effect of neoadjuvant therapy and the survival of patients with stage II and III NSCLC.
本研究旨在阐明实体瘤疗效评价标准（RECIST）、体积反应（VR；肿瘤体积缩小>50%）以及新辅助治疗后非小细胞肺癌（NSCLC）患者的新辅助治疗后最大标准化摄取值（post-SUVmax）的预测效用。在2006年12月至2012年6月期间，纳入了33例新辅助治疗后接受肺切除术的临床II期和III期NSCLC患者。分析了各变量与病理完全缓解（pCR）、无病生存期（DFS）和总生存期（OS）之间的关系。作为新辅助治疗，24例患者接受了放化疗，5例患者接受了化疗，4例患者接受了放疗。根据RECIST，12个肿瘤被分类为部分缓解，21个肿瘤被分类为疾病稳定。21个肿瘤显示有VR，12个没有。25个肿瘤的post-SUVmax≤7.5，8个肿瘤的post-SUVmax>7.5。8个肿瘤达到pCR。在多因素Cox回归分析中，非VR和post-SUVmax>7.5均为预测DFS的显著变量（分别为p = 0.0422和0.0127），但两者均不是OS的显著变量。post-SUVmax也是pCR率的显著变量（p = 0.0067）。治疗后的SUVmax可作为一个有效的替代变量，用于预测新辅助治疗的效果以及II期和III期NSCLC患者的生存期。
