Zhu Wenyao, Zhang Yan, Kong Li, Huang Yong, Zheng Jinsong, Wang Renben, Li Minghuan, Yu Jinming
School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Department of Radiation Oncology and Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China,
Onco Targets Ther. 2018 Jul 25;11:4345-4353. doi: 10.2147/OTT.S160456. eCollection 2018.
To evaluate the capability of F-fluorodeoxyglucose positron emission tomography/ computed tomography (F-FDG-PET/CT) to predict the clinical response of metastatic lymph node (mLN) to definitive chemoradiotherapy (dCRT) and guide personalized radiation dose in esophageal squamous cell carcinoma (ESCC) patients.
One hundred and forty-three mLNs from 59 patients with ESCC treated with dCRT and who had undergone a pretreatment F-FDG-PET/CT scan were included in the study. All defined mLNs were contoured by nuclear medicine radiologists. Response was evaluated by contrast-enhanced computed tomography and F-FDG-PET/CT.
Sixty-nine mLNs showed complete response (CR), and 74 mLNs showed non-complete response. The 143 mLNs were divided into 4 groups (Groups 1-4) based on the quartiles of maximum standardized uptake value (SUVmax-G1, SUVmax-G2, SUVmax-G3, and SUVmax-G4) and metabolic tumor volume (MTV-G1, MTV-G2, MTV-G3, and MTV-G4). The CR rate of SUVmax-G2 was significantly higher than the other 3 groups. The escalated radiation dose improved the CR rate of lymph nodes in SUVmax-G3 (55 Gy) and SUVmax-G4 (61 Gy). The lowest CR rate was found in MTV-G4 (the group with the largest MTV). The escalated radiation dose (59.7 Gy) improved the CR rate of lymph node in MTV-Groups 3 and 4.
Pretreatment metabolic parameters can predict the response of mLNs to dCRT for patients with ESCC. The parameters could also be used to guide personalized dose to mLNs.
评估¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸F-FDG-PET/CT）预测转移性淋巴结（mLN）对食管癌鳞状细胞癌（ESCC）患者根治性放化疗（dCRT）的临床反应以及指导个性化放射剂量的能力。
本研究纳入了59例接受dCRT治疗且在治疗前进行了¹⁸F-FDG-PET/CT扫描的ESCC患者的143个mLN。所有确定的mLN均由核医学放射科医生进行轮廓勾画。通过增强计算机断层扫描和¹⁸F-FDG-PET/CT评估反应。
69个mLN显示完全缓解（CR），74个mLN显示未完全缓解。根据最大标准化摄取值（SUVmax-G1、SUVmax-G2、SUVmax-G3和SUVmax-G4）和代谢肿瘤体积（MTV-G1、MTV-G2、MTV-G3和MTV-G4）的四分位数将143个mLN分为4组（第1-4组）。SUVmax-G2组的CR率显著高于其他3组。增加放射剂量提高了SUVmax-G3组（55 Gy）和SUVmax-G4组（61 Gy）淋巴结的CR率。MTV-G4组（MTV最大的组）的CR率最低。增加放射剂量（59.7 Gy）提高了MTV第3组和第4组淋巴结的CR率。
治疗前代谢参数可预测ESCC患者mLN对dCRT的反应。这些参数还可用于指导对mLN的个性化剂量。
