Department of Urology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 236-0004, Japan.
Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Cancer Chemother Pharmacol. 2018 Apr;81(4):739-744. doi: 10.1007/s00280-018-3542-7. Epub 2018 Feb 20.
We investigated prospectively whether F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) can predict the overall survival (OS) of patients with advanced renal cell carcinoma (RCC) previously treated by molecular targeted therapies.
Between 2009 and 2016, 81 patients who had received single molecular targeted therapies (43 sorafenib, 27 sunitinib, 8 temsirolimus and others) and were scheduled for second line molecular targeted therapies for advanced RCC were enrolled in this prospective study. FDG PET/CT was performed after first line molecular targeted therapies, the max SUVmax (highest standardized uptake value for each patient) recorded, and its association with OS compared with those of known risk factors. The median follow-up was 15.4 months (range 0.9-97.4 months).
The max SUVmax of the 81 subjects ranged from undetectable to 23.0 (median 7.1). Patients with high max SUVmax had a poor prognosis and multivariate analysis with established risk factors showed that it was an independent predictor of survival (p < 0.001; hazard ratio 1.156; 95% confidence interval 1.080-1.239). Subclassification of patients by max SUVmax showed that the median OS of patients with max SUVmax < 7.0 (39), 7.0-12.0 (30), and ≥ 12.0 (12) were 32.8, 15.2, and 6.0 months, respectively. These differences are statistically significant (< 7.0 versus 7.0-12.0: p = 0.0333, 7.0-12.0 versus ≥ 12.0: p = 0.0235).
The max SUVmax by FDG PET/CT of patients with RCC evaluated after their first molecular targeted therapy predicts OS. FDG PET/CT is a useful "imaging biomarker" for patients with advanced RCC planning sequential molecular targeted therapies.
我们前瞻性研究了氟-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）是否可以预测既往接受过分子靶向治疗的晚期肾细胞癌（RCC）患者的总生存期（OS）。
在 2009 年至 2016 年间，共纳入 81 例接受过单分子靶向治疗（43 例索拉非尼、27 例舒尼替尼、8 例替西罗莫司和其他药物）并计划接受二线分子靶向治疗的晚期 RCC 患者。这些患者在一线分子靶向治疗后进行 FDG PET/CT 检查，记录每位患者的最大标准化摄取值（max SUVmax），并将其与已知危险因素进行比较，以评估其与 OS 的相关性。中位随访时间为 15.4 个月（范围 0.9-97.4 个月）。
81 例患者的 max SUVmax 范围为未检出至 23.0（中位数为 7.1）。max SUVmax 较高的患者预后较差，多因素分析显示，max SUVmax 是生存的独立预测因素（p<0.001；风险比 1.156；95%置信区间 1.080-1.239）。根据 max SUVmax 对患者进行亚分类，max SUVmax<7.0（39 例）、7.0-12.0（30 例）和≥12.0（12 例）的患者中位 OS 分别为 32.8、15.2 和 6.0 个月，这些差异具有统计学意义（<7.0 与 7.0-12.0：p=0.0333，7.0-12.0 与≥12.0：p=0.0235）。
RCC 患者在接受首次分子靶向治疗后 FDG PET/CT 的 max SUVmax 可预测 OS。FDG PET/CT 是计划接受序贯分子靶向治疗的晚期 RCC 患者的一种有用的“成像生物标志物”。
