Department of Oncology, Nanfang Hospital, Southern Medical University Guangzhou, Guangdong Province, China.
PET Center, Nanfang Hospital, Southern Medical University Guangzhou, Guangdong Province, China.
Thorac Cancer. 2014 Jul;5(4):297-303. doi: 10.1111/1759-7714.12092. Epub 2014 Jul 3.
In this study, positron emission tomography-computed tomography (PET-CT) was used to monitor the maximal standard uptake value (SUVmax) in advanced lung adenocarcinoma patients with epithermal growth factor receptor (EGFR) mutation to prove its role in predicting the prognosis of targeted therapy.
A total of 46 patients with advanced lung adenocarcinoma (IIIb-IV stage) were enrolled in the current study. They were positive for EGFR mutation. All patients received gefitinib (250 mg per day, administered orally). PET-CT was conducted prior to (at baseline) and six months after gefitinib administration for the lesion size and SUVmax. The recommendations of the European Organization for Research and Treatment of Cancer criteria were chosen for PET assessment. Metabolic response (SUV decline < -25%) was compared with morphologic response evaluated by CT scan and overall survival.
Compared to patients with △SUV% ≥ 25% (progressive metabolic disease), the survival time was significantly prolonged in △SUV% < -25% (including complete metabolic response and progressive metabolic disease) (10.6/18.4, P = 0.000), but was not in -25% ≤ △SUV% < 25% (stable metabolic disease) (10.6/10.7, P = 0.088). Patients who achieved △SUV% < -25% after treatment were associated with a longer median survival, higher control rate, and better prognosis. There was a strong correlation between SUV changes (△SUV%) and CT size change (△lesion size%) (R(2) = 0.891, P = 0.000).
Changes in the SUV could be used to predict the prognosis of targeted therapy in advanced lung adenocarcinoma.
在这项研究中，我们使用正电子发射断层扫描-计算机断层扫描（PET-CT）监测表皮生长因子受体（EGFR）突变的晚期肺腺癌患者的最大标准摄取值（SUVmax），以证明其在预测靶向治疗预后中的作用。
本研究共纳入 46 例晚期肺腺癌（IIIb-IV 期）患者，EGFR 突变阳性。所有患者均接受吉非替尼（每天 250mg，口服）治疗。在吉非替尼治疗前（基线时）和 6 个月后对病变大小和 SUVmax 进行 PET-CT 检查。选择欧洲癌症研究与治疗组织的建议进行 PET 评估。代谢反应（SUV 下降＜-25%）与 CT 扫描评估的形态反应和总生存期进行比较。
与 SUV%≥25%（进行性代谢疾病）的患者相比，SUV%＜-25%（包括完全代谢反应和进行性代谢疾病）的生存时间明显延长（10.6/18.4，P=0.000），而 SUV%＜-25%的患者生存时间没有差异（10.6/10.7，P=0.088）。治疗后 SUV%＜-25%的患者中位生存时间更长，控制率更高，预后更好。SUV 变化（SUV%）与 CT 大小变化（病变大小%）之间具有很强的相关性（R²=0.891，P=0.000）。
SUV 的变化可用于预测晚期肺腺癌靶向治疗的预后。
