Katsui Kuniaki, Ogata Takeshi, Tada Akihiro, Watanabe Kenta, Yoshio Kotaro, Kuroda Masahiro, Kiura Katsuyuki, Hiraki Takao, Toyooka Shinichi, Kanazawa Susumu
Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Department of Radiology, Iwakuni Clinical Center, Iwakuni, Yamaguchi 740-8510, Japan.
Mol Clin Oncol. 2021 Apr;14(4):73. doi: 10.3892/mco.2021.2235. Epub 2021 Feb 23.
The purpose of the present study was to clarify whether positron emission tomography/computed tomography (PET/CT) volumetric parameters were prognostic predictors of non-small cell lung cancer (NSCLC) treatment in patients who had undergone preoperative concurrent chemoradiotherapy (CCRT) and surgery. In the present study, retrospectively surveyed the data of patients with NSCLC who underwent preoperative CCRT and surgery at Okayama University Hospital (Okayama, Japan) between April 2006 and March 2018. The maximum standardized uptake value (SUV) and volumetric parameters, including metabolic tumor volume (MTV) and total lesion glycolysis (TLG), were calculated using PET/CT and the percentage decrease (Δ) in each parameter value post-CCRT. The SUV threshold for defining MTV was set at 2.5. Furthermore, the association between survival and PET parameter values was analyzed. A total of 52 patients were included in the present study. The median follow-up period was 50.65 months. In univariate analysis, ΔTLG was identified to be a significant predictor of progression-free survival (PFS; P=0.03). The 5-year PFS rates were 48.6 and 76.6% for patients with low ΔTLG and high ΔTLG, respectively. High ΔTLG was indicative of a higher overall survival rate (P=0.08). The present results suggest that ΔTLG calculated using PET/CT is a prognostic predictor of NSCLC treated using preoperative CCRT and surgery, and may help physicians determine treatment strategies.
本研究的目的是阐明正电子发射断层扫描/计算机断层扫描（PET/CT）体积参数是否为接受术前同步放化疗（CCRT）和手术的非小细胞肺癌（NSCLC）患者治疗的预后预测指标。在本研究中，回顾性调查了2006年4月至2018年3月期间在日本冈山大学医院接受术前CCRT和手术的NSCLC患者的数据。使用PET/CT计算最大标准化摄取值（SUV）以及包括代谢肿瘤体积（MTV）和总病变糖酵解（TLG）在内的体积参数，并计算CCRT后各参数值的下降百分比（Δ）。定义MTV的SUV阈值设定为2.5。此外，分析了生存率与PET参数值之间的关联。本研究共纳入52例患者。中位随访期为50.65个月。在单因素分析中，ΔTLG被确定为无进展生存期（PFS）的显著预测指标（P = 0.03）。低ΔTLG和高ΔTLG患者的5年PFS率分别为48.6%和76.6%。高ΔTLG表明总生存率较高（P = 0.08）。目前的结果表明，使用PET/CT计算的ΔTLG是术前CCRT和手术治疗NSCLC的预后预测指标，可能有助于医生确定治疗策略。
