Braun L H, Reinert C P, Zips D, Nikolaou K, Pfannenberg C, Gani C
Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Germany.
Klinik für Strahlentherapie und Palliativmedizin, Marienhospital Stuttgart, Germany.
Clin Transl Radiat Oncol. 2020 Jun 18;24:83-87. doi: 10.1016/j.ctro.2020.06.008. eCollection 2020 Sep.
Anal cancer (AC) is a malignancy with increasing incidence and commonly treated with radiochemotherapy. Positron-emission tomography-computed tomography (PET/CT) has been shown to improve treatment outcome in various oncological diseases, however, for AC long-term outcome data is sparse. The aim of the present study is therefore to report outcomes in our cohort of PET/CT staged AC patients treated with radiochemotherapy.
Patients with AC who were treated with radiochemotherapy in curative intent were included in this retrospective study if a PET/CT scan was performed pre-therapeutically. Information from PET/CT was considered for nodal and primary target volume definition. Radiotherapy dose to the primary tumor was 50-66 Gy and concomitant chemotherapy included 5-fluorouracil and mitomycin-C. The uptake of F-fluorodeoxyglucose (FDG) was quantified using 50%-isocontour volumes of interests (VOIs) and measuring the standardized uptake value (SUV) and the metabolic tumor volume (MTV).F-FDG uptake was correlated with baseline clinical parameters and long-term oncological outcome. Survival estimates were determined according to Kaplan-Meier.
A total of 60 patients were included in this study. Estimates for three-year overall survival (OS) and disease free survival (DFS) were 94.5% and 80%. Five patients developed local (n = 2) or locoregional and local (n = 3) failure. Baseline PET/CT related parameters correlated with primary tumor stage, nodal stage and tumor grading. DFS was independent of T-stage, N-stage and baseline F-FDG-uptake.
In this cohort of PET/CT staged AC patients, excellent outcomes for DFS were seen. PET-based markers of tumor burden correlate with local stage of AC, however, are not of prognostic relevance for disease-free survival.
肛管癌（AC）是一种发病率不断上升的恶性肿瘤，通常采用放化疗进行治疗。正电子发射断层扫描-计算机断层扫描（PET/CT）已被证明可改善多种肿瘤疾病的治疗效果，然而，关于肛管癌的长期预后数据却很稀少。因此，本研究的目的是报告我们队列中接受放化疗的PET/CT分期肛管癌患者的预后情况。
本回顾性研究纳入了以治愈为目的接受放化疗的肛管癌患者，前提是在治疗前进行了PET/CT扫描。PET/CT的信息被用于确定淋巴结和原发靶区体积。原发肿瘤的放疗剂量为50-66Gy，同步化疗包括5-氟尿嘧啶和丝裂霉素-C。使用50%等剂量线感兴趣区（VOIs）对F-氟脱氧葡萄糖（FDG）摄取进行定量，并测量标准化摄取值（SUV）和代谢肿瘤体积（MTV）。F-FDG摄取与基线临床参数和长期肿瘤学预后相关。生存估计根据Kaplan-Meier法确定。
本研究共纳入60例患者。三年总生存率（OS）和无病生存率（DFS）估计分别为94.5%和80%。5例患者出现局部（n = 2）或局部区域和局部（n = 3）复发。基线PET/CT相关参数与原发肿瘤分期、淋巴结分期和肿瘤分级相关。DFS独立于T分期、N分期和基线F-FDG摄取。
在这个PET/CT分期的肛管癌患者队列中，观察到了良好的DFS结果。基于PET的肿瘤负荷标志物与肛管癌的局部分期相关，然而，对于无病生存没有预后意义。
