Wang Duo, Koh Eng-Siew, Descallar Joseph, Pramana Ariyanto, Vinod Shalini K, Ho Shon Ivan
The University of New South Wales, Sydney, Australia.
Concord Repatriation General Hospital, Sydney, Australia.
Asia Pac J Clin Oncol. 2016 Dec;12(4):349-358. doi: 10.1111/ajco.12587. Epub 2016 Aug 23.
Flurodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is routinely used in non-small-cell lung cancer. This study aims to assess the prognostic value of quantitative FDG-PET/CT parameters including standard uptake value (SUV), metabolic tumor volume (MTV) and total lesional glycolysis (TLG) in non-small-cell lung cancer.
A retrospective review of 92 nonsurgical patients with pathologically confirmed stage I-III non-small-cell lung cancers treated with radical dose radiotherapy (≥50 Gy) was conducted. Metabolically active tumor regions on FDG-PET/CT scans were contoured manually. SUV, MTV and TLG were calculated for primary, nodal and whole-body disease. Univariate and multivariate (adjusting for age, sex, disease stage and primary tumor size in centimeters) Cox regression modeling were performed to assess the association between these parameters and both overall and progression-free survival (PFS).
On univariate analysis, overall survival (OS) was significantly associated with primary MTV (P = 0.03), whole-body MTV (P = 0.02), whole-body maximum SUV (P = 0.05) and whole-body TLG (P = 0.03). PFS was significantly associated with primary MTV (P = 0.01), primary TLG (P = 0.04), whole-body MTV (P < 0.01) and whole-body TLG (P = 0.01). On multivariate analysis, OS was significantly associated with whole-body MTV (P = 0.05). PFS was significantly associated with whole-body MTV (P = 0.02) and whole-body TLG (P = 0.05).
Whole-body MTV was significantly associated with overall and PFS, and whole-body TLG was significantly associated with PFS on multivariate analysis. These two parameters may be significant prognostic factors independent of other factors such as stage. SUV was not significantly associated with survival on multivariate analysis.
氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）常用于非小细胞肺癌。本研究旨在评估包括标准摄取值（SUV）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）在内的定量FDG-PET/CT参数在非小细胞肺癌中的预后价值。
对92例接受根治性剂量放疗（≥50 Gy）的病理确诊为Ⅰ-Ⅲ期非小细胞肺癌的非手术患者进行回顾性研究。在FDG-PET/CT扫描上手动勾勒出代谢活跃的肿瘤区域。计算原发灶、淋巴结和全身疾病的SUV、MTV和TLG。进行单因素和多因素（校正年龄、性别、疾病分期和以厘米为单位的原发肿瘤大小）Cox回归建模，以评估这些参数与总生存期和无进展生存期（PFS）之间的关联。
单因素分析显示，总生存期（OS）与原发灶MTV（P = 0.03）、全身MTV（P = 0.02）、全身最大SUV（P = 0.05）和全身TLG（P = 0.03）显著相关。PFS与原发灶MTV（P = 0.01）、原发灶TLG（P = 0.04）、全身MTV（P < 0.01）和全身TLG（P = 0.01）显著相关。多因素分析显示，OS与全身MTV显著相关（P = 0.05）。PFS与全身MTV（P = 0.02）和全身TLG（P = 0.05）显著相关。
多因素分析显示，全身MTV与总生存期和PFS显著相关，全身TLG与PFS显著相关。这两个参数可能是独立于分期等其他因素的显著预后因素。多因素分析显示SUV与生存期无显著相关性。
