Kitajima Kazuhiro, Miyoshi Yasuo, Yamano Toshiko, Odawara Soichi, Higuchi Tomoko, Yamakado Koichiro
Department of Radiology, Division of Nuclear Medicine and PET Center, Hyogo College of Medicine, Nishinomiya, Japan.
Department of Breast and Endocrine Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Nagoya J Med Sci. 2018 May;80(2):183-197. doi: 10.18999/nagjms.80.2.183.
Therapeutic response to neoadjuvant chemotherapy (NAC) for breast cancer based on Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) 1.0 with FDG-PET/CT measurements was evaluated, and the results compared to those obtained with currently widely used Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, based on MRI measurements. MRI and FDG-PET/CT examinations were performed in 32 breast cancer patients before and after the NAC prior to a surgical resection. Chemotherapeutic response of the primary tumor and relapse-free survival (RFS) were investigated using RECIST 1.1 and PERCIST 1.0. Pathological complete response (pCR) was seen in 14 (43.8%) patients, while complete response (CR) was noted in 5, partial response in 25, stable disease in 2, and progressive disease in 0 with RECIST 1.1, and in 28, 2, 1, and 1, respectively, with PERCIST 1.0. For pCR prediction, the sensitivity, specificity, and accuracy with RECIST 1.1 were 28.6% (4/14), 94.4% (17/18), and 65.6% (21/32), and those with PERCIST 1.0 were 100% (14/14), 22.2% (4/18), and 56.3% (18/32). Five patients (15.6%) had recurrent development after a median period of 24 months (range 7.8-66.8 months). Patients who achieved CR shown by RECIST 1.1 showed slightly longer RFS than those who did not (p=0.46), whereas those with complete metabolic response (CMR) based on PERCIST 1.0 showed a relatively longer RFS than non-CMR patients (p=0.087). For prediction of pathological response to NAC in breast cancer, RECIST 1.1 and PERCIST 1.0 have complementary functions, however, FDG-PET as a post-NAC treatment assessment modality remains to be confirmed.
基于实体瘤正电子发射断层扫描反应标准（PERCIST）1.0及氟代脱氧葡萄糖正电子发射断层显像/X线计算机体层成像（FDG-PET/CT）测量结果，对乳腺癌新辅助化疗（NAC）的治疗反应进行了评估，并将结果与基于磁共振成像（MRI）测量、目前广泛使用的实体瘤反应评估标准（RECIST）1.1所获得的结果进行比较。在32例乳腺癌患者手术切除前，于NAC前后进行了MRI和FDG-PET/CT检查。使用RECIST 1.1和PERCIST 1.0研究原发肿瘤的化疗反应及无复发生存期（RFS）。RECIST 1.1标准下，14例（43.8%）患者出现病理完全缓解（pCR），5例出现完全缓解（CR），25例出现部分缓解，2例病情稳定，0例病情进展；PERCIST 1.0标准下，分别为28例、2例、1例和1例。对于pCR预测，RECIST 1.1的敏感性、特异性和准确性分别为28.6%（4/14）、94.4%（17/18）和65.6%（21/32），PERCIST 1.0的分别为100%（14/14）、22.2%（4/18）和56.3%（18/32）。5例患者（15.6%）在中位24个月（范围7.8 - 66.8个月）后出现复发。RECIST 1.1显示达到CR的患者的RFS略长于未达到CR的患者（p = 0.46），而基于PERCIST 1.0达到完全代谢反应（CMR）的患者的RFS相对长于非CMR患者（p = 0.087）。对于预测乳腺癌NAC的病理反应，RECIST 1.1和PERCIST 1.0具有互补功能，然而，FDG-PET作为NAC后治疗评估方式仍有待证实。
