Hasebe M, Yoshikawa K, Nishii R, Kawaguchi K, Kamada T, Hamada Y
Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, Tsurumi, Yokohama, Japan; The Hospital of the National Institute of Radiological Sciences, Chiba, Japan.
The Hospital of the National Institute of Radiological Sciences, Chiba, Japan; Tokyo Bay Advanced Imaging and Radiation Oncology Clinic, Toyosuna, Chiba, Japan.
Int J Oral Maxillofac Surg. 2017 Oct;46(10):1220-1228. doi: 10.1016/j.ijom.2017.04.019. Epub 2017 May 20.
The aim of this study was to determine whether l-methyl-[C]-methionine (MET) positron emission tomography (PET) allows the prediction of outcomes in patients with head and neck mucosal malignant melanoma treated with carbon ion radiation therapy (CIRT). This was a retrospective cohort study involving 85 patients who underwent a MET-PET or MET-PET/computed tomography (CT) examination before and after CIRT. MET uptake in the tumour was evaluated semi-quantitatively using the tumour-to-normal tissue ratio (TNR). Local recurrence, metastasis, and outcome predictions were studied in terms of TNR before CIRT (TNRpre), TNR after CIRT (TNRpost), and the TNR change ratio. Kaplan-Meier curves revealed significant differences between patients with higher TNRpre values and those with lower TNRpre values in regard to local recurrence, metastasis, and outcome (log-rank test P<0.0001 for all three). There were also significant differences in metastasis rates and outcomes between patients with higher and lower TNRpost values (log-rank test P=0.0105 and P=0.027, respectively). The Cox proportional hazards model revealed TNRpre to be a factor significantly influencing the risk of local recurrence (hazard ratio (HR) 29.0, P<0.001), risk of metastasis (HR 2.67, P=0.024), and the outcome (HR 6.3, P<0.001). MET-PET or MET-PET/CT is useful for predicting the outcomes of patients with head and neck mucosal malignant melanoma treated with CIRT.
本研究的目的是确定¹⁸F-甲基-[¹¹C]-蛋氨酸（MET）正电子发射断层扫描（PET）是否能够预测接受碳离子放射治疗（CIRT）的头颈部黏膜恶性黑色素瘤患者的预后。这是一项回顾性队列研究，纳入了85例在CIRT前后接受MET-PET或MET-PET/计算机断层扫描（CT）检查的患者。使用肿瘤与正常组织比值（TNR）对肿瘤中的MET摄取进行半定量评估。根据CIRT前的TNR（TNRpre）、CIRT后的TNR（TNRpost）和TNR变化率研究局部复发、转移和预后预测。Kaplan-Meier曲线显示，TNRpre值较高的患者与TNRpre值较低的患者在局部复发、转移和预后方面存在显著差异（所有三项的对数秩检验P<0.0001）。TNRpost值较高和较低的患者在转移率和预后方面也存在显著差异（对数秩检验P分别为0.0105和0.027）。Cox比例风险模型显示，TNRpre是显著影响局部复发风险（风险比（HR）29.0，P<0.001）、转移风险（HR 2.67，P=0.024）和预后（HR 6.3，P<0.001）的因素。MET-PET或MET-PET/CT有助于预测接受CIRT治疗的头颈部黏膜恶性黑色素瘤患者的预后。
