Kim Tae Hun, Kim Junhwan, Kang Yeon-Koo, Lee Maria, Kim Hee Seung, Cheon Gi Jeong, Chung Hyun Hoon
Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Transl Oncol. 2017 Jun;10(3):297-303. doi: 10.1016/j.tranon.2017.02.001. Epub 2017 Mar 15.
To evaluate the prognostic value of metabolic parameters derived from serial F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with advanced epithelial ovarian cancer (EOC).
Thirteen patients with advanced EOC who received surgical staging and adjuvant platinum-based combination chemotherapy were prospectively enrolled. F-FDG PET/CT was performed before and after the surgical staging, and after third cycle of chemotherapy. Tumor glucose metabolism at baseline and its change after operation and third cycle of chemotherapy such as changes of maximum standardized uptake values (ΔSUV) via F-FDG PET/CT were measured, and assessed regarding their ability to predict recurrence.
Median duration of progression-free survival (PFS) was 25 months (range, 13-34), and although optimal debulking was performed in 10 patients, 5 (38.5%) patients experienced recurrence. Univariate analyses showed significant associations between recurrence and low ΔSUV after surgical staging, and low SUV change after third cycle of chemotherapy. Multivariate analysis identified low ΔSUV after third cycle of chemotherapy as an independent risk factor for recurrence (P=.047, hazard ratio (HR) 16.375, 95% CI 1.041-257.536). Kaplan-Meier survival curves showed that PFS significantly differed in groups categorized based on ΔSUV after chemotherapy (P=.001, log-rank test).
F-FDG PET/CT allows for prediction of treatment response by the level of FDG uptake in terms of SUV at baseline and after chemotherapy. The metabolic response measured as ΔSUV after third cycle of chemotherapy appears to be promising predictor of recurrence in patients with advanced EOC.
评估连续F氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）得出的代谢参数对晚期上皮性卵巢癌（EOC）患者的预后价值。
前瞻性纳入13例接受手术分期及铂类辅助联合化疗的晚期EOC患者。在手术分期前后以及化疗第三个周期后进行F-FDG PET/CT检查。测量基线时肿瘤葡萄糖代谢情况及其在手术和化疗第三个周期后的变化，如通过F-FDG PET/CT测量的最大标准化摄取值变化（ΔSUV），并评估其预测复发的能力。
无进展生存期（PFS）的中位数为25个月（范围13 - 34个月），尽管10例患者进行了最佳肿瘤细胞减灭术，但仍有5例（38.5%）患者复发。单因素分析显示，复发与手术分期后低ΔSUV以及化疗第三个周期后低SUV变化之间存在显著关联。多因素分析确定化疗第三个周期后低ΔSUV是复发的独立危险因素（P = 0.047，风险比（HR）16.375，95%置信区间1.041 - 257.536）。Kaplan-Meier生存曲线显示，根据化疗后ΔSUV分组的患者PFS有显著差异（P = 0.001，对数秩检验）。
F-FDG PET/CT能够根据基线及化疗后SUV水平的FDG摄取情况预测治疗反应。化疗第三个周期后以ΔSUV衡量的代谢反应似乎是晚期EOC患者复发的有前景的预测指标。
