John Christopher, Venkatasai Jeyaanth, Kondaveeti Satish Srinivas, Murali Arunan, Periakaruppan Gokulakrishnan, E Venkatachalapathy, Meenakshisundaram Manickavasagam, Ambalathandi Ravi Chandran, Masilamani Hemavathi
Department of Radiation Oncology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India.
Department of Radio-Diagnosis, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India.
Contemp Oncol (Pozn). 2021;25(3):153-159. doi: 10.5114/wo.2021.109620. Epub 2021 Oct 1.
To evaluate the prognostic role of markers of fluor-18-fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG-PET-CT), such as maximum standard uptake value (SUV) and metabolic tumour volume (MTV) measured at primary and nodal disease, and their clinical significance in terms of predicting treatment outcomes and survival.
Between January 2017 and January 2020, 20 case records of nasopharyngeal carcinoma patients who underwent F-FDG-PET-CT as part of staging workup before radiotherapy and as a part of response evaluation after radiotherapy were retrospectively reviewed.
At a median follow-up of 34.7 months, the 2-year progression-free survival (PFS) was 70% and 2-year overall survival (OS) was 79%. Patients with a lower nodal SUV (SUV) had a better 2-year PFS (91% vs. 46%; = 0.035) and 2-year OS (95% vs. 58%; = 0.015). A high SUV of > 10.58 was a negative predictor of OS (95% confidence interval [CI]: 0.93-1; = 0.003) as well as PFS (95% CI: 0.64-1; = 0.017). Also, a high MTV > 25.8 cm was a negative predictor of PFS (95% CI: 0.58-0.98; = 0.048). MTV was an independent predictor of PFS and OS on univariate analysis, whereas it was not significant in the Cox regression multivariate analysis.
High values of MTV and SUV can be considered as independent prognostic factors of OS and PFS in nasopharyngeal cancer patients treated with concurrent chemoradiation, highlighting the need for more intensified treatment.
评估氟-18-氟脱氧葡萄糖正电子发射断层扫描与计算机断层扫描（F-FDG-PET-CT）的标志物的预后作用，例如在原发疾病和淋巴结疾病处测量的最大标准摄取值（SUV）和代谢肿瘤体积（MTV），以及它们在预测治疗结果和生存方面的临床意义。
回顾性分析2017年1月至2020年1月期间20例鼻咽癌患者的病例记录，这些患者在放疗前进行F-FDG-PET-CT作为分期检查的一部分，放疗后作为疗效评估的一部分。
中位随访34.7个月时，2年无进展生存率（PFS）为70%，2年总生存率（OS）为79%。淋巴结SUV较低的患者2年PFS更好（91%对46%；P = 0.035），2年OS更好（95%对58%；P = 0.015）。SUV>10.58是OS（95%置信区间[CI]：0.93 - 1；P = 0.003）以及PFS（95% CI：0.64 - 1；P = 0.017）的负性预测指标。此外，MTV>25.8 cm是PFS的负性预测指标（95% CI：0.58 - 0.98；P = 0.048）。单因素分析时MTV是PFS和OS的独立预测指标，而在Cox回归多因素分析中无显著性。
MTV和SUV的高值可被视为同步放化疗治疗的鼻咽癌患者OS和PFS的独立预后因素，突出了更强化治疗的必要性。
