Srinivas Kondaveeti Satish, Arunan M, Venkatachalapathy E, John Christopher, Manickavasagam M, Divyambika C V
Department of Radiotherapy, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Radiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
J Int Soc Prev Community Dent. 2019 Mar-Apr;9(2):159-165. doi: 10.4103/jispcd.JISPCD_409_18. Epub 2019 Apr 12.
This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUV) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy.
Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017-April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks' postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUV were recorded and correlated with immediate treatment response.
The mean pretherapy SUV of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUV of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUV was 3 months (range 2-5 months). The mean posttherapy SUV of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUV of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon-Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUV values for both primary tumor ( < 0.001) and regional node ( = 0.001). Majority of patients ( = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation.
Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUV in comparison to the pretherapy SUV it failed to identify a cutoff value for pretherapy SUV which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity.
本回顾性研究旨在将接受放化疗的头颈部鳞状细胞癌患者全身18氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）治疗前和治疗后的最大标准化摄取值（SUV）与肿瘤反应相关联。
本回顾性研究的数据取自前一年（2017年3月至2018年4月）在我院接受治疗和评估的20例可评估的头颈部癌患者的临床记录。上述所有患者均在我院接受了针对局部晚期头颈部鳞状细胞癌的放化疗，并在治疗前和治疗后进行了全身FDG PET扫描。建议在治疗完成8周后进行治疗后PET计算机断层扫描（CT）。在PET CT扫描期间，在注射FDG后1小时采集图像。记录治疗前和治疗后的SUV，并与即时治疗反应相关联。
原发肿瘤的平均治疗前SUV为10.27，范围为4.5至26.17。淋巴结的平均治疗前SUV为5.34，范围为0至17.9。记录治疗后SUV的平均时间为3个月（范围为2至5个月）。原发肿瘤的平均治疗后SUV为1.05，范围从完全代谢反应到6.4。淋巴结的平均治疗后SUV为0.7，范围从完全代谢反应到5.43。基于Wilcoxon符号秩检验的统计分析显示，原发肿瘤（<0.001）和区域淋巴结（=0.001）治疗前和治疗后的SUV值存在统计学显著差异。大多数患者（=15）显示临床缓解；然而，5例患者在评估时出现疾病进展。
尽管回顾性研究显示，与治疗前SUV相比，完全缓解者的治疗后SUV有统计学显著降低，但未能确定可预测治疗可能结果的治疗前SUV临界值。鉴于此，需要进行更大规模的前瞻性研究，纳入更多患者并包括各种其他肿瘤代谢标志物，以获得更清晰的结果。
