Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University; Center for Biomedical Imaging, Fudan University; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai 200032, China.
Sci Rep. 2017 Jan 16;7:40552. doi: 10.1038/srep40552.
The purpose of this study was to explore the feasibility of F-Fluorothymidine (F-FLT) and F-Fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) in predicting treatment response of nasopharyngeal carcinoma (NPC). Patients with NPC of Stage II-IVB were prospectively enrolled, receiving 2 cycles of neoadjuvant chemotherapy (NACT), followed by concurrent chemoradiotherapy. Each patient underwent pretreatment and post-NACT FLT PET/CT and FDG PET/CT. Standard uptake values (SUV) and tumor volume were measured. Tumor response to NACT was evaluated before radiotherapy by MRI (magnetic resonance imaging), and tumor regression at the end of radiotherapy was evaluated at 55 Gy, according to RECIST 1.1 Criteria. Finally, 20 patients were consecutively enrolled. At the end of radiotherapy, 7 patients reached complete regression while others were partial regression. After 2 cycles of NACT both FLT and FDG parameters declined remarkably. Parameters of FDG PET were more strongly correlated to tumor regression than those of FLT PET.70% SUVmax was the best threshold to define contouring margin around the target. Some residual lesions after NACT showed by MRI were negative in PET/CT. Preliminary results showed both F-FDG and F-FLT PET have the potential to monitor and predict tumor regression.
本研究旨在探讨氟代胸苷（F-FLT）和氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在预测鼻咽癌（NPC）治疗反应中的可行性。前瞻性纳入 II-IVB 期 NPC 患者，接受 2 个周期新辅助化疗（NACT），随后进行同期放化疗。每位患者均在治疗前和 NACT 后进行 FLT PET/CT 和 FDG PET/CT。测量标准摄取值（SUV）和肿瘤体积。通过磁共振成像（MRI）在放疗前评估 NACT 的肿瘤反应，并根据 RECIST 1.1 标准在 55Gy 时评估放疗结束时的肿瘤退缩情况。最终连续纳入 20 例患者。放疗结束时，7 例患者达到完全消退，其余患者为部分消退。NACT 后，FLT 和 FDG 参数均显著下降。与 FLT PET 相比，FDG PET 的参数与肿瘤退缩的相关性更强。70% SUVmax 是定义靶区周围轮廓边界的最佳阈值。MRI 显示的 NACT 后一些残留病变在 PET/CT 中为阴性。初步结果表明，F-FDG 和 F-FLT PET 均具有监测和预测肿瘤退缩的潜力。
