基线、治疗中期及治疗结束时F-FDG PET/CT对滤泡性淋巴瘤患者的预后价值
Prognostic values of baseline, interim and end-of therapy F-FDG PET/CT in patients with follicular lymphoma.
作者信息
Zhou Yeye, Zhao Zixuan, Li Jihui, Zhang Bin, Sang Shibiao, Wu Yiwei, Deng Shengming
机构信息
Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
出版信息
Cancer Manag Res. 2019 Jul 23;11:6871-6885. doi: 10.2147/CMAR.S216445. eCollection 2019.
PURPOSE
In the present study, we aimed to investigate the role of baseline, interim and end-of treatment positron emission tomography/computed tomography (PET/CT) in assessing the prognosis of follicular lymphoma (FL).
METHODS
A total of 84 FL patients were retrospectively analyzed in this study. Baseline (n=59), interim (n=24, after 2-4 cycles) and end-of treatment (n=43) PET/CT images were re-evaluated, and baseline maximum standardized uptake value (SUV), total metabolic tumor volume (tMTV) and total lesion glycolysis (TLG) were recorded. Interim (I-PET) and end-of treatment (E-PET) PET/CT responses were interpreted by Deauville five-point scale (D-5PS) and International Harmonization Project criteria (IHP). Survival curves were calculated by Kaplan-Meier curves, and differences between groups were compared by log-rank test.
RESULTS
The 2-year progression-free survival (PFS) of the high- and low-TLG groups was 57.14% and 95.56%, respectively (=0.0001). The 2-year overall survival (OS) of the high- and low-TLG groups was 62.50% and 100%, respectively (<0.0001). Multivariate analysis showed that TLG was an independent prognostic factor for PFS (=0.001, HR=6.577, 95% CI=2.167-19.960) and OS (=0.030, HR=19.291, 95% CI =2.689-137.947). Besides, Eastern Cooperative Oncology Group (ECOG) was the independent prognostic factor for OS (HR=8.924, 95% CI=1.273-62.559, =0.028). Interim PET results based on D-5PS or IHP criteria were not significantly correlated with PFS (all >0.05). However, E-PET results using D-5PS and IHP criteria were statistically significant (=0.0001 and =0.006). The D-5PS showed stronger prognostic value compared with IHP criteria. The optimal cutoff value of ΔSUV% was 66.95% according to I-PET and 68.97% according to E-PET. However, only the ΔSUV% from the baseline to the end-of therapy yielded statistically significant results in the prediction of PFS (=0.0002).
CONCLUSION
Our findings indicated that the baseline TLG and E-PET results were significantly associated with prognosis in patients with FL.
目的
在本研究中，我们旨在探讨基线、中期和治疗结束时的正电子发射断层扫描/计算机断层扫描（PET/CT）在评估滤泡性淋巴瘤（FL）预后中的作用。
方法
本研究对84例FL患者进行了回顾性分析。重新评估了基线（n = 59）、中期（n = 24，2 - 4个周期后）和治疗结束时（n = 43）的PET/CT图像，并记录了基线最大标准化摄取值（SUV）、总代谢肿瘤体积（tMTV）和总病变糖酵解（TLG）。中期（I - PET）和治疗结束时（E - PET）的PET/CT反应根据Deauville五点量表（D - 5PS）和国际协调项目标准（IHP）进行解读。通过Kaplan - Meier曲线计算生存曲线，并通过对数秩检验比较组间差异。
结果
高TLG组和低TLG组的2年无进展生存期（PFS）分别为57.14%和95.56%（P = 0.0001）。高TLG组和低TLG组的2年总生存期（OS）分别为62.50%和100%（P < 0.0001）。多因素分析显示，TLG是PFS（P = 0.001，HR = 6.577，95%CI = 2.167 - 19.960）和OS（P = 0.030，HR = 19.291，95%CI = 2.689 - 137.947）的独立预后因素。此外，东部肿瘤协作组（ECOG）状态是OS的独立预后因素（HR = 8.924，95%CI = 1.273 - 62.559，P = 0.028）。基于D - 5PS或IHP标准的中期PET结果与PFS无显著相关性（均P > 0.05）。然而，使用D - 5PS和IHP标准的E - PET结果具有统计学意义（P = 0.0001和P = 0.006）。与IHP标准相比，D - 5PS显示出更强的预后价值。根据I - PET，ΔSUV%的最佳截断值为66.95%，根据E - PET为68.97%。然而，仅从基线到治疗结束时的ΔSUV%在PFS预测中产生了具有统计学意义的结果（P = 0.0002）。
结论
我们的研究结果表明，基线TLG和E - PET结果与FL患者的预后显著相关。
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