（18）F-FDG PET/CT初始最大标准化摄取值对接受厄洛替尼治疗的转移性肺腺癌患者治疗反应的预后影响
Prognostic impact of initial maximum standardized uptake value of (18)F-FDG PET/CT on treatment response in patients with metastatic lung adenocarcinoma treated with erlotinib.
作者信息
Kus Tulay, Aktas Gokmen, Sevinc Alper, Kalender Mehmet Emin, Yilmaz Mustafa, Kul Seval, Oztuzcu Serdar, Oktay Cemil, Camci Celaletdin
机构信息
Department of Internal Medicine, Division of Medical Oncology, Gaziantep Oncology Hospital, University of Gaziantep, Gaziantep, Turkey.
Department of Nuclear Medicine, University of Gaziantep, Gaziantep, Turkey.
出版信息
Onco Targets Ther. 2015 Dec 15;8:3749-56. doi: 10.2147/OTT.S94945. eCollection 2015.
PURPOSE
To investigate whether the initial maximum standardized uptake value (SUVmax) on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has a prognostic significance in metastatic lung adenocarcinoma.
PATIENTS AND METHODS
Sixty patients (24 females, mean age: 57.9±12 years) with metastatic stage lung adenocarcinoma who used erlotinib and underwent (18)F-FDG PET/CT at the time of diagnosis between May 2010 and May 2014 were enrolled in this retrospective study. The patients were stratified according to the median SUVmax value, which was found as 11. Progression-free survival (PFS) rates for 3, 6, and 12 months were examined for SUVmax values and epidermal growth factor receptor (EGFR) mutation status.
RESULTS
The number of EGFR-sensitizing mutation positive/negative/unknown was 26/17/17, respectively, and the number of patients using erlotinib at first-line, second-line, and third-line therapy was 15, 31, and 14 consecutively. The PFS rates of EGFR mutation positive, negative, and unknown patients for 3 months were 73.1%, 35.3%, and 41.2% (P=0.026, odds ratio [OR]=4.39; 95% confidence interval [CI]: 1.45-13.26), respectively. The PFS rates of EGFR positive, negative, and unknown patients for 6 months were 50%, 29.4%, and 29.4% (P=0.267, OR: 2.4; 95% CI: 0.82-6.96), respectively. The PFS rates of EGFR positive, negative, and unknown patients for 12 months were 42.3%, 29.4%, 23.5% (P=0.408, OR: 2.0; 95% CI: 0.42-5.26), respectively. Thirty-one of 60 patients had SUVmax values ≤11. The PFS rates for 3, 6, and 12 months were 70.5%/28% (P=0.001, OR=9.0; 95% CI: 2.79-29.04), 61.7%/8% (P<0.001, OR=28.35; 95% CI: 5.5-143), and 52.9%/8% (P<0.001, OR=18.69; 95% CI: 3.76-92.9) for low SUVmax (≤11) group/high SUVmax (>11) group, respectively.
CONCLUSION
Initial SUVmax value on (18)F-FDG PET/CT is found to be a prognostic factor anticipating the response to erlotinib for 3, 6, and 12-month rates of PFS in both EGFR-sensitizing mutation and wild-type tumor group.
目的
探讨氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸F-FDG PET/CT）上的初始最大标准化摄取值（SUVmax）在转移性肺腺癌中是否具有预后意义。
患者与方法
本回顾性研究纳入了60例（24例女性，平均年龄：57.9±12岁）转移性肺腺癌患者，这些患者在2010年5月至2014年5月诊断时使用厄洛替尼并接受了¹⁸F-FDG PET/CT检查。患者根据SUVmax中位数分层，该中位数为11。对SUVmax值和表皮生长因子受体（EGFR）突变状态检查了3、6和12个月的无进展生存期（PFS）率。
结果
EGFR敏感突变阳性/阴性/未知的患者数分别为26/17/17例，一线、二线和三线治疗中使用厄洛替尼的患者数依次为15、31和14例。EGFR突变阳性、阴性和未知患者3个月的PFS率分别为73.1%、35.3%和41.2%（P = 0.026，比值比[OR]=4.39；95%置信区间[CI]：1.45 - 13.26）。EGFR阳性、阴性和未知患者6个月的PFS率分别为50%、29.4%和29.4%（P = 0.267，OR：2.4；95% CI：0.82 - 6.96）。EGFR阳性、阴性和未知患者12个月的PFS率分别为42.3%、29.4%、23.5%（P = 0.408，OR：2.0；95% CI：0.42 - 5.26）。60例患者中有31例SUVmax值≤11。低SUVmax（≤11）组/高SUVmax（>11）组3、6和12个月的PFS率分别为70.5%/28%（P = 0.001，OR = 9.0；95% CI：2.79 - 29.04）、61.7%/8%（P < 0.001，OR = 28.35；95% CI：5.5 - 143）和52.9%/8%（P < 0.001，OR = 18.69；95% CI：3.76 - 92.9）。
结论
发现在¹⁸F-FDG PET/CT上的初始SUVmax值是预测EGFR敏感突变组和野生型肿瘤组中厄洛替尼治疗3、6和12个月PFS率反应的一个预后因素。
Zotero 插件