原发灶与淋巴结 PET/CT 反应作为调强放疗治疗口咽鳞癌的预后标志物。
Primary vs nodal site PET/CT response as a prognostic marker in oropharyngeal squamous cell carcinoma treated with intensity-modulated radiation therapy.
机构信息
Department of Radiation Medicine, Northwell Health, New Hyde Park, New York, USA.
Department of Radiation Oncology, Methodist Health System, Omaha, Nebraska, USA.
出版信息
Head Neck. 2020 Sep;42(9):2405-2413. doi: 10.1002/hed.26242. Epub 2020 May 11.
BACKGROUND
Positron emission tomography/computed tomography (PET/CT) in staging of advanced oropharyngeal squamous cell carcinoma (OPSCC) and at 3 months posttreatment (PETpost) is often utilized to assess response. The significance of lymph node vs primary site treatment response is incompletely understood.
METHODS
We reviewed 230 patients treated with radiation therapy. PETpost response was graded at primary and nodal sites and correlated with survival.
RESULTS
Median age was 58, and 83% were p16-positive. Median follow-up was 24.3 months. Nodal response at PETpost predicted improved 2-year local recurrence-free survival (LRFS) (93% vs 72%, P =.004), 2-year disease-free survival (DFS) (80% vs 61.3%, P =.021), and 2-year overall survival (OS) (89% vs 83%, P =.051), while primary response only predicted improved 2-year LRFS (91% vs 76% P = .035).
CONCLUSION
In OPSCC patients, both nodal and primary response at 3 months on PET/CT predicted for improved LRFS, but only nodal response predicted DFS and OS.
背景
正电子发射断层扫描/计算机断层扫描（PET/CT）在晚期或口咽鳞状细胞癌（OPSCC）的分期和治疗后 3 个月（PETpost）中经常用于评估反应。淋巴结和原发部位治疗反应的意义尚不完全清楚。
方法
我们回顾了 230 例接受放射治疗的患者。对原发和淋巴结部位的 PETpost 反应进行分级，并与生存相关联。
结果
中位年龄为 58 岁，83%为 p16 阳性。中位随访时间为 24.3 个月。PETpost 时的淋巴结反应预测了 2 年局部无复发生存率（LRFS）（93%比 72%，P=0.004）、2 年无病生存率（DFS）（80%比 61.3%，P=0.021）和 2 年总生存率（OS）（89%比 83%，P=0.051）的改善，而原发反应仅预测了 2 年 LRFS 的改善（91%比 76%，P=0.035）。
结论
在 OPSCC 患者中，PET/CT 在 3 个月时的淋巴结和原发部位反应均预测了 LRFS 的改善，但只有淋巴结反应预测了 DFS 和 OS。
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