Ma Jun, Wu Xiaojing, Li Jianghong, Wang Zhihua, Wang Yi
Department of Thoracic surgery, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, China.
Department of Respiratory Medicine, Heji Hospital Affiliated to Changzhi Medical College, Changzhi, China.
J Investig Med. 2017 Jun;65(5):935-941. doi: 10.1136/jim-2017-000433. Epub 2017 Mar 30.
The purpose of this meta-analysis was to determine the prognostic value of early response assessment using (18F)fluorodeoxyglucose (FDG)-positron emission thermography (PET) in patients with advanced non-small cell lung cancer (NSCLC) treated with tyrosine-kinase inhibitors (TKIs). MEDLINE, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until August 1, 2016 using the keywords non-small cell lung carcinoma, positron-emission tomography, fluorodeoxyglucose, prognosis, disease progression, survival, erlotinib, gefitinib, and afatinib. Inclusion criteria were studies of patients with stage III or IV NSCLC treated with a TKI and had response assessed by FDG-PET. Outcome measures were overall survival (OS) and progression-free survival (PFS). Of the 167 articles identified, 10 studies including 302 patients were included in the analysis. In 8 studies, patients were treated with erlotinib, and in 2 they were treated with gefitinib. The overall analysis revealed that early metabolic response was statistically associated with improved OS (HR=0.54; 95% CI 0.46 to 0.63; p<0.001), and with longer PFS (HR=0.23; 95% CI 0.17 to 0.33; p<0.001). Early response of patients with NSCLC treated with TKIs identified on FDG-PET is associated with improved OS and PFS.
本荟萃分析的目的是确定使用（18F）氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）进行早期反应评估对接受酪氨酸激酶抑制剂（TKIs）治疗的晚期非小细胞肺癌（NSCLC）患者的预后价值。使用关键词非小细胞肺癌、正电子发射断层扫描、氟脱氧葡萄糖、预后、疾病进展、生存、厄洛替尼、吉非替尼和阿法替尼对MEDLINE、PubMed、Cochrane、EMBASE和谷歌学术数据库进行检索，直至2016年8月1日。纳入标准为对III期或IV期NSCLC患者使用TKI治疗且通过FDG-PET评估反应的研究。观察指标为总生存期（OS）和无进展生存期（PFS）。在识别出的167篇文章中，10项研究（包括302例患者）纳入分析。8项研究中患者接受厄洛替尼治疗，2项研究中患者接受吉非替尼治疗。总体分析显示，早期代谢反应与OS改善具有统计学相关性（HR=0.54；95%CI 0.46至0.63；p<0.001），且与更长的PFS相关（HR=0.23；95%CI 0.17至0.33；p<0.001）。FDG-PET识别出的接受TKIs治疗的NSCLC患者的早期反应与OS和PFS改善相关。
