Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, España.
Servicio de Oncología Radioterápica, Complejo Hospitalario Universitario de Badajoz, Badajoz, España.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 Nov-Dec;39(6):353-359. doi: 10.1016/j.remn.2020.05.008. Epub 2020 Jun 27.
To assess the utility of F-FDG PET/CT quantitative parameters as prognostic factor in patients diagnosed with localized and inoperable lung cancer treated by stereotactic body radiotherapy (SBRT).
Fifty patients (42 men) diagnosed in the last 7years with early-stage lung cancer and treated with SBRT alone were assessed by a prospective study. After PET/CT study, metabolic parameters maximum SUV (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were determined at different thresholds. The prognostic factors for overall survival (OS), cause-specific survival (CS) and disease-free survival (DFS) were analysed by Cox proportional hazards model and the survival analysis by Kaplan-Meier method.
The average follow-up was 39.6months, with 21 recurrences and 24 dead. Univariate analysis determined MTV and MTV as predictors for OS; MTV, MTV, TLG and TLG for CS, and MTV, MTV, MTV, TLG, TLG and TLG for DFS. Survival analysis found statistically significant differences for CS and DFS depending on tumor size and for DFS considering the cut-off values of MTV and TLG (threshold SUVmax=2). SUVmax, age and sex were not shown to be significant factors.
Pre-treatment quantitative assessment using metabolic parameters MTV and TLG as well as tumor size proved to be prognostic factors in patients diagnosed with localized and inoperable lung cancer treated by SBRT. Results could help to personalize treatment.
评估 F-FDG PET/CT 定量参数作为局部不可切除肺癌患者立体定向体部放疗（SBRT）后预后因素的作用。
对过去 7 年中通过 SBRT 单独治疗的 50 名（42 名男性）早期肺癌患者进行前瞻性研究。在进行 PET/CT 研究后，根据不同阈值确定最大标准摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）等代谢参数。通过 Cox 比例风险模型分析总生存（OS）、无病生存（DFS）和特异性生存（CS）的预后因素，通过 Kaplan-Meier 方法进行生存分析。
平均随访 39.6 个月，21 例复发，24 例死亡。单因素分析确定 MTV 和 MTV 是 OS 的预测因素；MTV、MTV、TLG 和 TLG 是 CS 的预测因素，而 MTV、MTV、MTV、TLG、TLG 和 TLG 是 DFS 的预测因素。生存分析发现 CS 和 DFS 与肿瘤大小有关，DFS 还与 MTV 和 TLG 的截止值（SUVmax=2）有关，存在统计学差异。SUVmax、年龄和性别均未显示为显著因素。
使用代谢参数 MTV 和 TLG 以及肿瘤大小进行的治疗前定量评估，是局部不可切除肺癌患者接受 SBRT 治疗后的预后因素。结果有助于个性化治疗。
