体积4'-[甲基-C]-硫代胸苷PET/CT参数对头颈部癌患者临床结局预测的影响

Influence of volumetric 4'-[methyl-C]-thiothymidine PET/CT parameters for prediction of the clinical outcome of head and neck cancer patients.

作者信息

Hoshikawa Hiroshi, Mori Terushige, Maeda Yukito, Takahashi Satoshi, Ouchi Yohei, Yamamoto Yuka, Nishiyama Yoshihiro

机构信息

Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.

Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.

出版信息

Ann Nucl Med. 2017 Jan;31(1):63-70. doi: 10.1007/s12149-016-1131-6. Epub 2016 Sep 27.

DOI:10.1007/s12149-016-1131-6

PMID:27679399

Abstract

OBJECTIVE

This prospective study compared the value of pretreatment 4'-[methyl-C]-thiothymidine (C-4DST) volumetric parameters and those of 2-deoxy-2-[18F] fluoro-D-glucose (F-FDG) in predicting the clinical outcome in patients with head and neck squamous cell carcinoma (HNSCC).

METHODS

Fifty patients with HNSCC underwent C-4DST PET/CT and F-FDG PET/CT prior to anticancer therapy. F-FDG metabolic tumor volume (F-FDG MTV) and total lesion glycolysis (TLG) were calculated from F-FDG PET, and C-4DST MTV and total lesion proliferation (TLP) were calculated from C-4DST PET. All parameters were measured for the primary lesion and metastatic lymph nodes. Associations between clinical factors and PET/CT parameters and prognostic value were analyzed.

RESULTS

Receiver-operating characteristic analysis revealed that MTV, TLG, and TLP acquired from the primary lesion and metastatic lymph nodes were good parameters for predicting disease relapse and death. The area under the curves (AUCs) ranged from 0.63 to 0.71 for F-FDG PET/CT parameters. The AUCs of C-4DST PET/CT parameters were larger than those of F-FDG (range 0.72-0.81). Univariate analysis revealed that individuals with tumors showing a high value for any PET/CT parameter were at a significantly increased risk of relapse. Upon multivariate analysis, F-FDG MTV, C-4DST MTV and C-4DST TLP were significant independent factors for relapse-free survival (P = 0.04, P = 0.0001 and P = 0.0005, respectively).

CONCLUSION

Pretreatment C-4DST PET/CT volume-based parameters can provide important prognostic information about patients with HNSCC.

摘要

目的

本前瞻性研究比较了治疗前4'-[甲基 - C] - 硫代胸苷（C - 4DST）体积参数和2 - 脱氧 - 2 - [18F]氟 - D - 葡萄糖（F - FDG）在预测头颈部鳞状细胞癌（HNSCC）患者临床结局方面的价值。

方法

50例HNSCC患者在抗癌治疗前接受了C - 4DST PET/CT和F - FDG PET/CT检查。从F - FDG PET计算F - FDG代谢肿瘤体积（F - FDG MTV）和总病变糖酵解（TLG），从C - 4DST PET计算C - 4DST MTV和总病变增殖（TLP）。对原发灶和转移淋巴结测量所有参数。分析临床因素与PET/CT参数之间的关联以及预后价值。

结果

受试者工作特征分析显示，从原发灶和转移淋巴结获得的MTV、TLG和TLP是预测疾病复发和死亡的良好参数。F - FDG PET/CT参数的曲线下面积（AUC）范围为0.63至0.71。C - 4DST PET/CT参数的AUC大于F - FDG的AUC（范围为0.72 - 0.81）。单因素分析显示，任何PET/CT参数值高的肿瘤患者复发风险显著增加。多因素分析显示，F - FDG MTV、C - 4DST MTV和C - 4DST TLP是无复发生存的显著独立因素（分别为P = 0.04、P = 0.0001和P = 0.0005）。