正电子发射断层扫描上的氟脱氧葡萄糖摄取是疼痛性骨转移患者姑息性放射治疗后长期疼痛控制的有用预测指标：一项单机构前瞻性研究的结果
Fluorodeoxyglucose Uptake on Positron Emission Tomography Is a Useful Predictor of Long-Term Pain Control After Palliative Radiation Therapy in Patients With Painful Bone Metastases: Results of a Single-Institute Prospective Study.
作者信息
Tahara Takatoshi, Fujii Shinya, Ogawa Toshihide, Michimoto Koichi, Fukunaga Takeru, Tanino Tomohiko, Uchida Nobue, Matsuki Tsutomu, Sakamoto Hiroaki
机构信息
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan.
出版信息
Int J Radiat Oncol Biol Phys. 2016 Feb 1;94(2):322-8. doi: 10.1016/j.ijrobp.2015.10.036. Epub 2015 Oct 30.
PURPOSE
To determine whether fluorodeoxyglucose positron emission tomography (FDG-PET) before and after palliative radiation therapy (RT) can predict long-term pain control in patients with painful bone metastases.
METHODS AND MATERIALS
Thirty-one patients with bone metastases who received RT were prospectively included. Forty painful metastatic treatment fields were evaluated. All patients had undergone pre-RT and post-RT PET/CT scanning. We evaluated the relationships between the pre-RT, post-RT, and changes in maximum standardized uptake value (SUVmax) and the pain response, and between SUVmax and pain relapse of the bone metastases in the treatment field. In addition, we compared the SUVmax according to the length of time from the completion of RT to pain relapse of the bone metastases.
RESULTS
Regarding the pain response at 4 weeks after the completion of RT, there were 36 lesions of 27 patients in the responder group and 4 lesions of 4 patients in the nonresponder group. Changes in the SUVmax differed significantly between the responder and nonresponder groups in both the early and delayed phases (P=.0292 and P=.0139, respectively), but no relationship was observed between the pre-RT and post-RT SUVmax relative to the pain response. The responder group was evaluated for the rate of relapse. Thirty-five lesions of 26 patients in the responder group were evaluated, because 1 patient died of acute renal failure at 2 months after RT. Twelve lesions (34%) showed pain relapse, and 23 lesions (66%) did not. There were significant differences between the relapse and nonrelapse patients in terms of the pre-RT (early/delayed phases: P<.0001/P<.0001), post-RT (P=.0199/P=.0261), and changes in SUVmax (P=.0004/P=.004).
CONCLUSIONS
FDG-PET may help predict the outcome of pain control in the treatment field after palliative RT for painful bone metastases.
目的
确定姑息性放射治疗（RT）前后的氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）是否能够预测伴有疼痛性骨转移患者的长期疼痛控制情况。
方法和材料
前瞻性纳入31例接受RT治疗的骨转移患者。对40个疼痛性转移治疗区域进行评估。所有患者均在RT治疗前和治疗后接受了PET/CT扫描。我们评估了RT治疗前、治疗后以及最大标准化摄取值（SUVmax）变化与疼痛反应之间的关系，以及SUVmax与治疗区域骨转移疼痛复发之间的关系。此外，我们根据从RT治疗结束到骨转移疼痛复发的时间长度比较了SUVmax。
结果
关于RT治疗结束后4周时的疼痛反应，反应组中27例患者有36个病灶，无反应组中4例患者有4个病灶。反应组和无反应组在早期和延迟期的SUVmax变化均有显著差异（分别为P = 0.0292和P = 0.0139），但相对于疼痛反应，RT治疗前和治疗后的SUVmax之间未观察到相关性。对反应组进行复发率评估。由于1例患者在RT治疗后2个月死于急性肾衰竭，因此对反应组中26例患者的35个病灶进行了评估。12个病灶（34%）出现疼痛复发，23个病灶（66%）未复发。复发患者和未复发患者在RT治疗前（早期/延迟期：P < 0.0001/P < 0.0001）、治疗后（P = 0.0199/P = 0.0261）以及SUVmax变化方面（P = 0.0004/P = 0.004）存在显著差异。
结论
FDG-PET可能有助于预测姑息性RT治疗疼痛性骨转移后治疗区域的疼痛控制结果。
Zotero 插件