Vanhove Karolien, Mesotten Liesbet, Heylen Micheline, Derwael Ruben, Louis Evelyne, Adriaensens Peter, Thomeer Michiel, Boellaard Ronald
Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, B-3500 Hasselt, Belgium.
Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, B-3500 Hasselt, Belgium; Ziekenhuis Oost Limburg, Schiepse Bos 6, 3600 Genk, Belgium.
Cancer Treat Res Commun. 2018;15:7-12. doi: 10.1016/j.ctarc.2017.11.005. Epub 2017 Dec 6.
To predict the outcome of patients with non-small cell lung cancer (NSCLC) the currently used prognostic system (TNM) is not accurate enough. The prognostic significance of the SUV measured by PET remains controversial. This study aims to evaluate the prognostic value in overall survival and progression free survival of SUV, the total lesion glycolysis (TLG) and the mean metabolic active volume (MATV) in NSCLC.
We retrospectively reviewed 105 patients (72 males, 33 females) with a new diagnosis of NSCLC (TNM stage I: 27.6%, II: 10.5%, III: 40.9% and IV: 21.0%) who underwent scanning with a PET/CT. For VOI definition a semi-automatic delineation tool was used. On PET images SUV, SUV and MATV of the primary tumor and the whole tumor burden were measured. TLG and MATV were measured by using a threshold of 50% of SUV.
OS and PFS are found to be higher in patients with low-SUV and low-TLG values. OS and PFS were significantly higher for low-SUV, low-MATV and low-TLG values of the whole-tumor burden. Multivariate analysis of the whole-tumor burden revealed that the most important prognostic factors for OS are high MATV and TLG values, increasing stage and male gender. TLG and stage are also independent prognosticators in PFS.
Only whole-body TLG is of prognostic value in NSCLC for both OS and PFS. Stratification of patients by TLG might complement outcome prediction but the TNM stage remains the most important determinant of prognosis.
In order to predict the outcome of patients with non-small cell lung cancer (NSCLC) the currently used prognostic system (TNM) is not accurate enough. The prognostic significance of the standard uptake value (SUV) measured by PET remains controversial. This study aims to evaluate the prognostic value in overall survival (OS) and progression free survival (PFS) of the standard uptake value (SUV), the total lesion glycolysis (TLG) and the mean metabolic active volume (MATV) in NSCLC. The study reveals that TLG of the whole-tumor burden is an independent prognostic factor for OS and PFS in patients with NSCLC.
为预测非小细胞肺癌（NSCLC）患者的预后，目前使用的预后系统（TNM）不够准确。通过PET测量的SUV的预后意义仍存在争议。本研究旨在评估SUV、总病灶糖酵解（TLG）和平均代谢活性体积（MATV）在NSCLC患者总生存期和无进展生存期方面的预后价值。
我们回顾性分析了105例新诊断为NSCLC的患者（72例男性，33例女性）（TNM分期：I期占27.6%，II期占10.5%，III期占40.9%，IV期占21.0%），这些患者均接受了PET/CT扫描。对于感兴趣区（VOI）的定义，使用了半自动勾画工具。在PET图像上测量原发肿瘤以及整个肿瘤负荷的SUV、TLG和MATV。TLG和MATV通过使用SUV的50%阈值进行测量。
发现SUV和TLG值低的患者总生存期（OS）和无进展生存期（PFS）更长。整个肿瘤负荷的低SUV、低MATV和低TLG值的患者，其OS和PFS显著更高。对整个肿瘤负荷进行多因素分析显示，OS最重要的预后因素是高MATV和TLG值、分期增加以及男性性别。TLG和分期也是PFS的独立预后因素。
在NSCLC中，仅全身TLG对OS和PFS均具有预后价值。根据TLG对患者进行分层可能有助于完善预后预测，但TNM分期仍然是预后的最重要决定因素。
为预测非小细胞肺癌（NSCLC）患者的预后，目前使用的预后系统（TNM）不够准确。通过PET测量的标准摄取值（SUV）的预后意义仍存在争议。本研究旨在评估标准摄取值（SUV）、总病灶糖酵解（TLG）和平均代谢活性体积（MATV）在NSCLC患者总生存期（OS）和无进展生存期（PFS）方面的预后价值。该研究表明，整个肿瘤负荷的TLG是NSCLC患者OS和PFS的独立预后因素。
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