治疗前 F-FDG 摄取异质性可预测局部复发性鼻咽癌碳离子放疗的治疗效果。
Pretreatment F-FDG uptake heterogeneity can predict treatment outcome of carbon ion radiotherapy in patients with locally recurrent nasopharyngeal carcinoma.
机构信息
Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China.
Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Shanghai, 201315, China.
出版信息
Ann Nucl Med. 2021 Jul;35(7):834-842. doi: 10.1007/s12149-021-01621-8. Epub 2021 Apr 28.
OBJECTIVE
Our study was to investigate the value of pretreatment F-FDG uptake heterogeneity to predict the prognosis of patients with locally recurrent nasopharyngeal carcinoma (LRNPC) treated by carbon ion radiotherapy (CIRT).
METHODS
Twenty-nine LRNPC patients who underwent whole-body F-FDG PET/CT scanning before CIRT were enrolled. Heterogeneity index (HI)-based F-FDG uptake, and the PET/CT traditional parameters, including SUVmax, MTV, and TLG were assessed. Receiver operator characteristics (ROC) determined the best cutoff value, and local recurrence-free survival (LRFS) and progression-free survival (PFS) were evaluated by the Kaplan-Meier method and log-rank test. And the predictive ability was evaluated by the ROC curve. Cox analyses were performed on LRFS and PFS.
RESULTS
In this study, univariate analysis showed that HI was a significant predictor of LRNPC treated by CIRT. HI could be used to predict LRFS and PFS. Patients with HI (≥ 0.81) had a significantly worse prognosis of LRFS (12.25 vs. NR, p = 0.008), and of PFS (10.58 vs. NR, p = 0.014). The AUC and its sensitivity and sensitivity and specificity were 0.75, 84.21% and 70.00% for LRFS and 0.82, 80.95% and 75.00% for PFS, respectively. Multivariate analysis showed that HI was an independent predictor for the LFRS of LRNPC with CIRT.
CONCLUSION
F-FDG uptake heterogeneity may be useful for predicting the prognosis of patients with LRNPC treated by CIRT.
目的
本研究旨在探讨治疗前氟代脱氧葡萄糖（FDG）摄取异质性对碳离子放疗（CIRT）治疗局部复发性鼻咽癌（LRNPC）患者预后的预测价值。
方法
本研究共纳入 29 例接受 CIRT 前全身 F-FDG PET/CT 扫描的 LRNPC 患者。评估了基于异质性指数（HI）的 FDG 摄取，以及 PET/CT 传统参数，包括 SUVmax、MTV 和 TLG。受试者工作特征（ROC）曲线确定最佳截断值，Kaplan-Meier 法和对数秩检验评估局部无复发生存（LRFS）和无进展生存（PFS）。ROC 曲线评估预测能力。对 LRFS 和 PFS 进行 Cox 分析。
结果
单因素分析显示，HI 是 CIRT 治疗 LRNPC 的显著预测因子。HI 可用于预测 LRFS 和 PFS。HI（≥0.81）患者的 LRFS（12.25 与 NR，p=0.008）和 PFS（10.58 与 NR，p=0.014）明显更差。LRFS 的 AUC 及其敏感性、特异性分别为 0.75、84.21%和 70.00%，PFS 的 AUC 及其敏感性、特异性分别为 0.82、80.95%和 75.00%。多因素分析显示，HI 是 CIRT 治疗 LRNPC 患者 LRFS 的独立预测因子。
结论
FDG 摄取异质性可能有助于预测接受 CIRT 治疗的 LRNPC 患者的预后。
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