18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描作为局部晚期非小细胞肺癌反应预测指标的疗效

Efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography as a predictor of response in locally advanced non-small-cell carcinoma of the lung.

作者信息

Roy Soumyajit, Pathy Sushmita, Kumar Rakesh, Mohanti Bidhu K, Raina Vinod, Jaiswal Anand, Taywade Sameer, Garg Kavita, Thulkar Sanjay, Mohan Anant, Mathur Sandeep, Behera Digamber

机构信息

Departments of aRadiation Oncology bMedical Oncology cRadiodiagnosis, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences Departments of dNuclear Medicine ePulmonary Medicine fPathology, All India Institute of Medical Sciences gDepartment of Chest Medicine, Lala Ram Swarup Institute of Tuberculosis & Respiratory Diseases, New Delhi, India hDepartment of Radiology, University of Colorado, Denver, Colorado, USA.

出版信息

Nucl Med Commun. 2016 Feb;37(2):129-38. doi: 10.1097/MNM.0000000000000422.

DOI:10.1097/MNM.0000000000000422

PMID:26544097

Abstract

OBJECTIVE

The study assessed the role of (18)F-fluorodeoxyglucose ((18)F-FDG) Positron emission tomography (PET)/computed tomography (CT) in evaluating the prognostic value of metabolic response for progression-free survival (PFS) and overall survival (OS) in patients with locally advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

Thirty patients with locally advanced NSCLC were enrolled in this prospective study and randomly allocated to one of two treatment arms. Arm A (n=15) received two cycles of neoadjuvant chemotherapy [paclitaxel (200 mg/m(2)) and carboplatin (AUC5)] and external beam radiotherapy (60 Gy/30 fractions/6 weeks). Arm B (n=15) received the same neoadjuvant chemotherapy followed by external beam radiotherapy (48 Gy/20 fractions/4 weeks) with concomitant cisplatin 30 mg/m(2) weekly. Patients underwent (18)F-FDG PET/CT at baseline and after 6 weeks of completion of intended treatment. Pretreatment and post-treatment maximum standardized uptake values (SUVmax) were noted. Patients with a reduction of SUVmax more than 50% were considered to be metabolic responders and those with a reduction 50% or less as nonresponders. Median follow-up was 18.98 months.

RESULTS

Twenty-one patients completed the intended treatment. The median pretreatment and post-treatment SUVmax values were 14 and 6.4 for arm A and 15.3 and 3.5 for arm B, respectively. Significant decrease in SUVmax was observed in both arms. Metabolic response in arm A and arm B was 50 and 64%, respectively. The median PFS and OS of the responders were 22.31 and 24.73 months and those for nonresponders were 7.83 and 8.26 months, respectively. No significant difference in OS and PFS was observed between responders and nonresponders in the two arms.

CONCLUSION

PET/CT distinguishes responders from nonresponders early after completion of chemoradiation in patients with locally advanced NSCLC, but did not provide any prognostic significance.

摘要

目的

本研究评估了18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）在评估局部晚期非小细胞肺癌（NSCLC）患者无进展生存期（PFS）和总生存期（OS）的代谢反应预后价值中的作用。

患者与方法

30例局部晚期NSCLC患者纳入本前瞻性研究，并随机分配至两个治疗组之一。A组（n = 15）接受两个周期的新辅助化疗[紫杉醇（200mg/m²）和卡铂（AUC5）]及外照射放疗（60Gy/30次/6周）。B组（n = 15）接受相同的新辅助化疗，随后进行外照射放疗（48Gy/20次/4周），同时每周给予顺铂30mg/m²。患者在基线及完成预定治疗6周后接受18F-FDG PET/CT检查。记录治疗前及治疗后的最大标准化摄取值（SUVmax）。SUVmax降低超过50%的患者被视为代谢反应者，降低50%或更低者为无反应者。中位随访时间为18.98个月。

结果

21例患者完成了预定治疗。A组治疗前及治疗后的SUVmax中位值分别为14和6.4，B组分别为15.3和3.5。两组的SUVmax均显著降低。A组和B组的代谢反应率分别为50%和64%。反应者的中位PFS和OS分别为22.31个月和24.73个月，无反应者分别为7.83个月和8.26个月。两组反应者与无反应者之间的OS和PFS无显著差异。