Ito Hiroki, Kondo Keiichi, Kawahara Takashi, Kaneta Tomohiro, Tateishi Ukihide, Ueno Daiki, Namura Kazuhiro, Kobayashi Kazuki, Miyoshi Yasuhide, Yumura Yasushi, Makiyama Kazuhide, Hayashi Narihiko, Hasumi Hisashi, Osaka Kimito, Yokomizo Yumiko, Teranishi Jun-Ichi, Hattori Yusuke, Inoue Tomio, Uemura Hiroji, Yao Masahiro, Nakaigawa Noboru
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Cancer Chemother Pharmacol. 2017 May;79(5):855-861. doi: 10.1007/s00280-017-3275-z. Epub 2017 Mar 22.
We evaluated F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) results as outcome predictors for patients with metastatic renal cell carcinoma (RCC) treated by everolimus (EVL), an inhibitor of mammalian target of rapamycin.
We retrospectively reviewed 30 patients who were treated with EVL for metastatic RCC between May 2010 and March 2015, by evaluating their FDG PET/CT result before and 1 month after starting EVL treatment. We examined the relationships between each patient's maximum standardized uptake value (max SUVmax) assessed by FDG PET/CT on progression-free survival (PFS) and overall survival (OS).
Median PFS for all 30 patients was 3.77 months (range 0.72-24.56 months) and median OS after EVL treatment of all 30 patients was 11.67 months (range 1.0-62.98 months). Enrolled patients were divided into two groups by max SUVmax prior to EVL (median = 7.6) and at 1 month after EVL treatment (median = 5.7). PFS were significantly shorter in higher max SUVmax prior to EVL (<7.6, PFS 7.8 vs 3.5 months, log-rank P = 0.017) and at 1 month after EVL (<5.7, PFS 10.6 vs 2.7 months, log-rank P = 0.002) than lower max SUVmax. OS were also significantly shorter in higher max SUVmax prior to EVL (<7.6, OS 18.1 vs 7.5 months, log-rank P = 0.010) and at 1 month after EVL (<5.7, OS 17.2 vs 7.5 months, log-rank P = 0.009) than lower max SUVmax. Multivariate Cox hazard regression analysis indicated that max SUVmax at 1 month after EVL is an independent predictor of both PFS and OS in patients treated with EVL although univariate regression analysis showed max SUVmax before EVL is a possible predictor.
Max SUVmax assessed by FDG PET/CT prior to EVL and at 1 month after EVL treatment can accurately predict PFS and can guide decisions on whether to continue or change treatments for patients with EVL-treated RCC who suffer from adverse events.
我们评估了F-2-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）结果，作为接受雷帕霉素哺乳动物靶点抑制剂依维莫司（EVL）治疗的转移性肾细胞癌（RCC）患者的预后预测指标。
我们回顾性分析了2010年5月至2015年3月期间接受EVL治疗转移性RCC的30例患者，评估他们在开始EVL治疗前及治疗1个月后的FDG PET/CT结果。我们研究了每位患者通过FDG PET/CT评估的最大标准化摄取值（max SUVmax）与无进展生存期（PFS）和总生存期（OS）之间的关系。
所有30例患者的中位PFS为3.77个月（范围0.72 - 24.56个月），所有30例患者接受EVL治疗后的中位OS为11.67个月（范围1.0 - 62.98个月）。根据EVL治疗前（中位值 = 7.6）和治疗1个月后（中位值 = 5.7）的max SUVmax，将入选患者分为两组。EVL治疗前max SUVmax较高组（<7.6，PFS为7.8个月对3.5个月，对数秩检验P = 0.017）和治疗1个月后max SUVmax较高组（<5.7，PFS为10.6个月对2.7个月，对数秩检验P = 0.002）的PFS显著短于max SUVmax较低组。EVL治疗前max SUVmax较高组（<7.6，OS为18.1个月对7.5个月，对数秩检验P = 0.010）和治疗1个月后max SUVmax较高组（<5.7，OS为17.2个月对7.5个月，对数秩检验P = 0.009）的OS也显著短于max SUVmax较低组。多因素Cox风险回归分析表明，EVL治疗1个月后的max SUVmax是接受EVL治疗患者PFS和OS的独立预测指标，尽管单因素回归分析显示EVL治疗前的max SUVmax是一个可能的预测指标。
EVL治疗前及治疗1个月后通过FDG PET/CT评估的max SUVmax可以准确预测PFS，并可为患有不良事件的接受EVL治疗的RCC患者是否继续或改变治疗方案的决策提供指导。
