Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Gynecologic Cancer Research Center, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Eur J Nucl Med Mol Imaging. 2018 Jul;45(7):1197-1204. doi: 10.1007/s00259-018-3957-8. Epub 2018 Feb 22.
To assess the clinical roles of [F]fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) performed 2-3 months after completion of concurrent chemoradiotherapy (CCRT), along with pretherapy characteristics, in patients with advanced squamous cell carcinoma of the uterine cervix enrolled in a prospective randomized clinical trial.
Posttherapy PET/CT in patients with advanced FIGO stage or positive pelvic or para-aortic lymph node (PALN) defined on pretherapy PET/CT was classified as positive, equivocal, or negative. Overall survival (OS) rates between patients with different PET/CT results are compared. Pretherapy characteristics are examined for association with posttherapy PET/CT results and for prognostic significance in patients with equivocal or negative PET/CT.
PET/CT scans (n = 55) were positive, equivocal and negative in 9, 13 and 33 patients, respectively. All patients with positive scans were confirmed to have residual or metastatic disease and died despite salvage therapies. There is a significant OS difference between patients with positive and equivocal scans (P < .001) but not between patients with equivocal and negative scans (P = .411). Positive pretherapy PALN is associated with positive posttherapy PET/CT (P = .033) and predicts a poorer survival in patients with equivocal or negative posttherapy PET/CT (P < .001).
Positive PET/CT 2-3 months posttherapy implies treatment failure and novel therapy is necessary to improve outcomes for such patients. A more intense posttherapy surveillance may be warranted in patients with positive pretherapy PALN.
评估在同步放化疗（CCRT）完成后 2-3 个月进行的 [F]氟脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）的临床作用，以及前瞻性随机临床试验中入组的晚期宫颈鳞状细胞癌患者的治疗前特征。
对治疗后 PET/CT 显示晚期 FIGO 分期或治疗前 PET/CT 阳性的盆腔或腹主动脉旁淋巴结（PALN）的患者进行分类，分为阳性、不确定或阴性。比较不同 PET/CT 结果患者的总生存（OS）率。检查治疗前特征与治疗后 PET/CT 结果的相关性，以及在 PET/CT 不确定或阴性患者中的预后意义。
PET/CT 扫描（n=55）阳性、不确定和阴性分别为 9、13 和 33 例。所有阳性扫描的患者均被证实有残留或转移性疾病，尽管进行了挽救治疗，但仍死亡。阳性和不确定扫描患者的 OS 差异有统计学意义（P<.001），但不确定和阴性扫描患者的 OS 差异无统计学意义（P=.411）。阳性治疗前 PALN 与阳性治疗后 PET/CT 相关（P=.033），并预测治疗后 PET/CT 不确定或阴性患者的生存更差（P<.001）。
治疗后 2-3 个月的阳性 PET/CT 提示治疗失败，需要新的治疗方法来改善此类患者的预后。对于治疗前 PALN 阳性的患者，可能需要更密集的治疗后监测。
