Metser Ur, Dudebout Jill, Baetz Tara, Hodgson David C, Langer Deanna L, MacCrostie Pamela, Mak Victor, Tau Noam
Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Department of Oncology, Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada.
Cancer. 2017 Aug 1;123(15):2860-2866. doi: 10.1002/cncr.30672. Epub 2017 Mar 13.
To measure the clinical impact of pretreatment fludeoxyglucose positron emission tomography/computed tomography (PET/CT) on the staging and management of apparent limited stage indolent lymphoma being considered for curative radiation therapy.
We conducted a prospective multicenter registry study that included 197 patients accrued between May 1, 2012, and December 31, 2015. Pre-PET/CT stage, determined by clinical and CT data, was documented. If pre-PET/CT stage was indeterminate, a stage was assigned to the patient by the referring oncologist according to best clinical judgment and treatment intent. After PET/CT, revised stage and planned management were recorded and compared with data on actual treatment received available through provincial databases (n = 155).
PET/CT resulted in the upstaging of 47 (23.9%) patients with presumed limited stage disease (stage I-II) to advanced stage disease (stage III-IV) (P < .0001). Ten (5.1%) patients were downstaged by PET/CT, 4 of whom migrated from advanced to limited stage disease. Twenty-eight (14.2%) patients with a specific pre-PET/CT stage had equivocal PET/CT findings that required further evaluation to confirm disease extent. After PET/CT, 95 (61.3%) patients were planned to receive active treatment. Of the 59 patients planned for radiotherapy alone post-PET/CT, 34 (57.6%) received this treatment (P = .002), and nearly 80% of them (n = 27) had confirmed limited stage disease.
PET/CT has a significant impact on staging and management in patients with apparent limited stage indolent lymphoma who are being considered for curative radiotherapy. PET/CT should be routinely incorporated into the workup of these patients. Cancer 2017;123:2860-66. © 2017 American Cancer Society.
评估治疗前氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）对拟行根治性放射治疗的浅表局限期惰性淋巴瘤分期及治疗管理的临床影响。
我们开展了一项前瞻性多中心注册研究，纳入了2012年5月1日至2015年12月31日期间入组的197例患者。记录由临床和CT数据确定的PET/CT检查前分期。如果PET/CT检查前分期不明确，转诊的肿瘤学家根据最佳临床判断和治疗意图为患者指定一个分期。PET/CT检查后，记录修订后的分期和计划的治疗管理，并与通过省级数据库获得的实际接受治疗的数据（n = 155）进行比较。
PET/CT使47例（23.9%）推定局限期疾病（I-II期）患者的分期上调至晚期疾病（III-IV期）（P <.0001）。10例（5.1%）患者经PET/CT检查后分期下调，其中4例从晚期疾病转变为局限期疾病。28例（14.2%）PET/CT检查前有特定分期的患者PET/CT检查结果不明确，需要进一步评估以确认疾病范围。PET/CT检查后，95例（61.3%）患者计划接受积极治疗。在PET/CT检查后计划仅接受放疗的59例患者中，34例（57.6%）接受了这种治疗（P =.002），其中近80%（n = 27）确诊为局限期疾病。
PET/CT对拟行根治性放疗的浅表局限期惰性淋巴瘤患者的分期及治疗管理有显著影响。PET/CT应常规纳入这些患者的检查流程。《癌症》2017年；123:2860 - 66。© 2017美国癌症协会。
