Christensen Tine Nøhr, Andersen Per Kragh, Langer Seppo W, Fischer Barbara Malene Bjerregaard
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, 2100 Copenhagen Ø, Denmark.
Cluster for Molecular Imaging, University of Copenhagen, 2200 Copenhagen N, Denmark.
Diagnostics (Basel). 2021 Jan 26;11(2):174. doi: 10.3390/diagnostics11020174.
Many studies have suggested a prognostic value of one or several positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC). However, studies are often small, and there is a considerable interstudy disagreement about which PET parameters have a prognostic value. The objective of this study was to perform a review and meta-analysis to identify the most promising PET parameter for prognostication. PubMed, Cochrane, and Embase were searched for papers addressing the prognostic value of any PET parameter at any treatment phase with any endpoint in patients with SCLC. Pooled hazard ratios (HRs) were calculated by a random effects model for the prognostic value of the baseline maximum standardized uptake value (SUV) and metabolic tumor volume (MTV). The qualitative analysis included 38 studies, of these, 19 studies were included in the meta-analyses. The pooled results showed that high baseline MTV was prognostic for overall survival (OS) (HR: 2.83 (95% confidence interval [CI]: 2.00-4.01) and progression-free survival (PFS) (HR: 3.11 (95% CI: 1.99-4.90)). The prognostic value of SUV was less pronounced (OS: HR: 1.50 (95% CI: 1.17-1.91); PFS: HR: 1.24 (95% CI: 0.94-1.63)). Baseline MTV is a strong prognosticator for OS and PFS in patients with SCLC. MTV has a prognostic value superior to those of other PET parameters, but whether MTV is superior to other prognosticators of tumor burden needs further investigation.
许多研究表明，一个或几个正电子发射断层扫描（PET）参数对小细胞肺癌（SCLC）患者具有预后价值。然而，研究规模往往较小，而且对于哪些PET参数具有预后价值，不同研究之间存在相当大的分歧。本研究的目的是进行一项综述和荟萃分析，以确定最有前景的用于预后评估的PET参数。在PubMed、Cochrane和Embase数据库中检索了关于SCLC患者在任何治疗阶段、以任何终点评估任何PET参数预后价值的论文。采用随机效应模型计算基线最大标准化摄取值（SUV）和代谢肿瘤体积（MTV）预后价值的合并风险比（HR）。定性分析纳入了38项研究，其中19项研究纳入了荟萃分析。汇总结果显示，高基线MTV对总生存期（OS）（HR：2.83（95%置信区间[CI]：2.00 - 4.01））和无进展生存期（PFS）（HR：3.11（95%CI：1.99 - 4.90））具有预后意义。SUV的预后价值不太显著（OS：HR：1.50（95%CI：1.17 - 1.91）；PFS：HR：1.24（95%CI：0.94 - 1.63））。基线MTV是SCLC患者OS和PFS的有力预后指标。MTV的预后价值优于其他PET参数，但MTV是否优于其他肿瘤负荷预后指标仍需进一步研究。
