Dag Zedef, Yilmaz Burcak, Dogan Ayse Kutluhan, Aksan Donay Unluer, Ozkurt Huseyin, Kızılkaya Hazim Orhan, Arslan Deniz
Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Radiation Oncology Department, Istanbul, Turkey.
Health Sciences University, Istanbul Research and Training Hospital, Nuclear Medicine Department, Istanbul, Turkey.
Brachytherapy. 2019 Mar-Apr;18(2):154-162. doi: 10.1016/j.brachy.2018.11.005. Epub 2018 Dec 26.
To evaluate the effect of metabolic parameters of pretreatment primary tumor and regional lymph nodes with F-18-FDG PET/CT compared with MRI findings for the prognostic value and disease-free survival (DFS) in locally advanced cervical cancer.
From 2011 to 2016, 112 patients with a diagnosis of cervical cancer stages IB2-IVA treated with concomitant chemoradiation therapy with 3D intracavitary brachytherapy were analyzed. From this group, 50 patients who underwent pretreatment and posttreatment FDG PET/CT and MRI were enrolled. LRFFS, DFS, and overall survival were analyzed in comparison with FDG PET/CT and MRI data. Relationship between SUVmax data and DFS was also assessed.
The median followup was 21 months, and median age was 54 years. The estimated 5-year locoregional failure-free survival, DFS, and overall survival rates were 87.4%, 70%, and 81%, respectively. DFS was 59.5% in patients with nodal metastases in FDG PET/CT and 100% in node negative patients (p:0,017). DFS was 50% and 79.4% in MRI node-positive and in node-negative patients, respectively (p:0,260). In addition, the nodal SUVmax (p: 0.005) and posttreatment response in FDG PET-CT (p < 0.001) were significant prognostic factors for DFS. Furthermore, primary tumor volume in MRI (p:0,982), node positivity in MRI (p:0,301), and response in posttreatment MRI (p:0,26) are not significant prognostic factors for DFS.
As a result, FDG PET/CT has higher accuracy than MRI in detecting lymph node metastasis, and tumor volume reduction on FDG PET/CT images was greater than that on MRI images after CCRT.
评估与MRI检查结果相比，采用F-18-FDG PET/CT检测局部晚期宫颈癌治疗前原发肿瘤及区域淋巴结的代谢参数对预后价值和无病生存期（DFS）的影响。
分析2011年至2016年期间112例经三维腔内近距离放疗同步放化疗治疗的IB2-IVA期宫颈癌患者。从该组中选取50例行治疗前和治疗后FDG PET/CT及MRI检查的患者。将LRFFS、DFS和总生存期与FDG PET/CT及MRI数据进行比较分析。还评估了SUVmax数据与DFS之间的关系。
中位随访时间为21个月，中位年龄为54岁。估计5年局部区域无复发生存率、DFS和总生存率分别为87.4%、70%和81%。FDG PET/CT显示有淋巴结转移的患者DFS为59.5%，淋巴结阴性患者为100%（p = 0.017）。MRI检查淋巴结阳性和阴性患者的DFS分别为50%和79.4%（p = 0.260）。此外，淋巴结SUVmax（p = 0.005）和FDG PET-CT治疗后反应（p < 0.001）是DFS的显著预后因素。此外，MRI检查的原发肿瘤体积（p = 0.982）、MRI检查的淋巴结阳性（p = 0.301）以及治疗后MRI检查的反应（p = 0.26）不是DFS的显著预后因素。
因此，FDG PET/CT在检测淋巴结转移方面比MRI具有更高的准确性，同步放化疗后FDG PET/CT图像上的肿瘤体积缩小大于MRI图像。
