Mohammadkhani Shali Siamak, Schmitt Vanessa, Behrendt Florian F, Winz Oliver H, Heinzel Alexander, Mottaghy Felix M, Eble Michael J, Verburg Frederik A
RWTH Aachen University Hospital, Departments of Nuclear Medicine, Germany.
RWTH Aachen University Hospital, Departments of Radiation therapy and Radiooncology, Germany.
Eur J Radiol. 2016 Aug;85(8):1390-4. doi: 10.1016/j.ejrad.2016.05.009. Epub 2016 May 20.
to determine whether [(18)F]2-fluoro-2-deoxyglucose (FDG) positron emission tomography and X-ray computed tomography (PET/CT) findings and metabolic parameters before combined chemo- and radiotherapy (CRT) have a prognostic value in patients with anal carcinoma.
45 patients with anal cancer who underwent pre-treatment FDG-PET/CT were included. Metabolic parameters, recurrence and anal carcinoma specific survival were analyzed.
SUV max and metabolic volume of the primary tumour were significantly higher in patients with lymph node or distant metastases than in those with locally confined disease (p=0.020 and p=0.015, respectively). The extent of disease (local tumour only, lymph node or distant metastases) was highly predictive of both for recurrence free and disease specific survival (p=0.010 and p<0.001, respectively). Recurrence free (p=0.010) and anal carcinoma specific survival (p=0.006) differed significantly between patients with a metabolic volume ≤45ml and >45ml. Multivariate analysis revealed that a metabolic volume >45ml was the only significant independent determinant (p=0.19) for recurrence free survival whereas for anal carcinoma specific survival the extent of disease was identified as the only significant independent determinant (p=0.002).
the extent of disease on FDG PET/CT before combined radio-chemotherapy is strongly predictive of prognosis in anal cancer. Furthermore, patients with a large metabolic volume of the primary tumour (>45ml) are at significantly higher risk of recurrence.
确定在联合放化疗（CRT）前，[(18)F]2-氟-2-脱氧葡萄糖（FDG）正电子发射断层扫描和X线计算机断层扫描（PET/CT）的检查结果及代谢参数对肛管癌患者是否具有预后价值。
纳入45例行治疗前FDG-PET/CT检查的肛管癌患者。分析代谢参数、复发情况及肛管癌特异性生存率。
有淋巴结或远处转移的患者，其原发肿瘤的最大标准摄取值（SUV max）和代谢体积显著高于局限性疾病患者（分别为p = 0.020和p = 0.015）。疾病范围（仅局部肿瘤、淋巴结或远处转移）对无复发生存率和疾病特异性生存率均具有高度预测性（分别为p = 0.010和p<0.001）。代谢体积≤45ml和>45ml的患者，其无复发生存率（p = 0.010）和肛管癌特异性生存率（p = 0.006）差异显著。多因素分析显示，代谢体积>45ml是无复发生存率的唯一显著独立决定因素（p = 0.19），而对于肛管癌特异性生存率，疾病范围是唯一显著独立决定因素（p = 0.002）。
放化疗前FDG PET/CT显示的疾病范围对肛管癌预后具有强烈预测性。此外，原发肿瘤代谢体积大（>45ml）的患者复发风险显著更高。
