Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Vancouver Centre, and Department of Surgery, Faculty of Medicine, Vancouver, BC.
Department of Radiation Oncology and Developmental Therapeutics, BC Cancer-Centre for the North, and Department of Surgery, Faculty of Medicine, Prince George, BC.
Curr Oncol. 2019 Feb;26(1):e57-e63. doi: 10.3747/co.26.4167. Epub 2019 Feb 1.
Stereotactic ablative radiotherapy (sabr) is a relatively new technique for the curative-intent treatment of patients with inoperable early-stage non-small-cell lung cancer (nsclc). Previous studies have demonstrated a prognostic value for positron emission tomography-computed tomography (pet/ct) parameters, including maximal standardized uptake value (suv), metabolic tumour volume (mtv), and total lesion glycolysis (tlg) in lung cancer patients. We aimed to determine which pet/ct parameter is most prognostic of local control (lc) and overall survival (os) in patients treated with sabr for nsclc.
We conducted a retrospective review of patients treated with sabr for stage I inoperable nsclc at BC Cancer between 2009 and 2013. The Akaike information criterion was used to compare the prognostic value of the various pet/ct parameters.
The study included 134 patients with a median age of 76 years. Median tumour diameter was 2.2 cm, gross tumour volume was 8.1 mL, suv was 7.9, mtv was 2.4 mL, and tlg was 10.9 suv·mL. The 2-year lc was 92%, and os was 66%. On univariate and multivariate analysis, imaging variables including tumour size, gross tumour volume, suv, mtv, and tlg were all associated with worse lc. Tumour size was not associated with significantly worse os, but other imaging variables were. The pet/ct parameter most prognostic of lc was mtv. Compared with suv, tlg and mtv were more prognostic of os.
In patients with early-stage nsclc treated with sabr, mtv appears to be prognostic of lc and os.
立体定向消融放疗(SABR)是一种治疗不能手术的早期非小细胞肺癌(NSCLC)的新技术。先前的研究已经证明,正电子发射断层扫描-计算机断层扫描(PET/CT)参数,包括最大标准化摄取值(SUV)、代谢肿瘤体积(MTV)和总肿瘤糖酵解(TLG),对肺癌患者具有预后价值。我们旨在确定在接受 SABR 治疗的 NSCLC 患者中,哪种 PET/CT 参数对局部控制(LC)和总生存(OS)的预测价值最高。
我们对 2009 年至 2013 年在 BC 癌症中心接受 SABR 治疗 I 期不可手术 NSCLC 的患者进行了回顾性研究。Akaike 信息准则用于比较各种 PET/CT 参数的预后价值。
该研究纳入了 134 例中位年龄为 76 岁的患者。肿瘤直径中位数为 2.2cm,肿瘤总体积为 8.1mL,SUV 为 7.9,MTV 为 2.4mL,TLG 为 10.9SUV·mL。2 年 LC 为 92%,OS 为 66%。单因素和多因素分析显示,包括肿瘤大小、肿瘤总体积、SUV、MTV 和 TLG 在内的影像学变量均与较差的 LC 相关。肿瘤大小与 OS 无显著相关性,但其他影像学变量与 OS 相关。对 LC 最具预测性的 PET/CT 参数是 MTV。与 SUV 相比,TLG 和 MTV 对 OS 的预测性更高。
在接受 SABR 治疗的早期 NSCLC 患者中,MTV 似乎对 LC 和 OS 具有预测价值。