Department of Radiation Oncology, Kangwon National University Hospital, Chuncheon, Korea.
Department of Nuclear Medicine, The Armed Forces Daejeon Hospital, Daejeon, Korea.
J Gynecol Oncol. 2019 Sep;30(5):e66. doi: 10.3802/jgo.2019.30.e66.
To perform a systematic review and meta-analysis of the prognostic value of post-treatment ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in uterine cervical cancer patients treated with radiotherapy (RT) with or without chemotherapy.
PubMed and Embase databases were searched up to July 22, 2018, for studies which evaluated the response outcomes of ¹⁸F-FDG PET following RT, and their prognostic significance in uterine cervical cancer was assessed with overall survival (OS) or progression-free survival (PFS) as endpoints. Hazard ratios (HRs) were meta-analytically pooled using the random-effects model.
Eleven studies with 12 patient cohorts including 1,104 patients were included. For a quantitative synthesis of OS, 7 cohorts were included. Two cohorts which reported disease-specific survival instead of OS were also included with flexibility. Pooled HR of complete metabolic response (CMR) compared to partial metabolic response (PMR) was 0.19 (95% confidence interval [CI]=0.11-0.31). Pooled HR of CMR compared to progressive metabolic disease (PMD) was more evident at 0.07 (95% CI=0.04-0.12), and that of CMR compared to both PMR and PMD was 0.20 (95% CI=0.12-0.34). Quantitative synthesis for PFS was performed with a total of 8 cohorts. Pooled HR of CMR was 0.17 (95% CI=0.10-0.29) compared to PMR, 0.02 (95% CI=0.01-0.06) compared to PMD and 0.12 (95% CI=0.07-0.19) compared to both PMR and PMD.
Response results of post-RT ¹⁸F-FDG PET were significant prognostic factors in patients with uterine cervical cancer, and ¹⁸F-FDG PET could be a reasonable follow-up imaging modality.
系统评价和荟萃分析宫颈癌患者在接受放化疗或单纯放疗后 ¹⁸F-氟脱氧葡萄糖正电子发射断层扫描（¹⁸F-FDG PET）的预后价值。
检索 PubMed 和 Embase 数据库，截至 2018 年 7 月 22 日，评估 ¹⁸F-FDG PET 治疗后反应结果的研究，并评估其作为终点的总生存率（OS）或无进展生存率（PFS）的预后意义。使用随机效应模型对风险比（HRs）进行荟萃分析。
共纳入 11 项研究，包含 1104 例患者的 12 个患者队列。对 OS 的定量分析纳入了 7 个队列。另外，还纳入了两个报告疾病特异性生存率而非 OS 的队列。CMR 与 PMR 相比，完全代谢反应（CMR）的合并 HR 为 0.19（95%置信区间[CI]=0.11-0.31）。CMR 与进行性代谢疾病（PMD）相比，合并 HR 更明显，为 0.07（95%CI=0.04-0.12），CMR 与 PMR 和 PMD 相比，合并 HR 为 0.20（95%CI=0.12-0.34）。对 PFS 进行了总共 8 个队列的定量合成。CMR 的合并 HR 为 0.17（95%CI=0.10-0.29）与 PMR 相比，0.02（95%CI=0.01-0.06）与 PMD 相比，0.12（95%CI=0.07-0.19）与 PMR 和 PMD 相比。
放化疗后 ¹⁸F-FDG PET 的反应结果是宫颈癌患者的显著预后因素，¹⁸F-FDG PET 可以作为一种合理的随访影像学方法。
