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分析预测骨髓肉瘤放疗反应的 PET 参数。

Analysis of PET parameters predicting response to radiotherapy for myeloid sarcoma.

机构信息

Department of Radiation Oncology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Radiation Oncology, Incheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

PLoS One. 2021 Dec 20;16(12):e0261550. doi: 10.1371/journal.pone.0261550. eCollection 2021.

Abstract

PURPOSE

Positron-emission tomography (PET)-CT has recently been used for diagnostic imaging and radiotherapy for myeloid sarcoma, but there is little research on predicting the response of radiotherapy. The aim of this study was to analyze the association between PET-CT variables and the response to radiotherapy in patients with myeloid sarcoma.

MATERIALS AND METHODS

This study was conducted in myeloid sarcoma patients who received radiotherapy and PET-CT before and after radiotherapy. The response to radiotherapy was evaluated based on the European Organization for Research and Treatment of Cancer PET response criteria, and binary regression analysis was performed to assess the factors predicting reductions in the maximum standardized uptake value (SUVmax).

RESULTS

Twenty-seven sites in 12 patients were included in the study. Complete metabolic responses were seen in 24 patients after radiotherapy, a partial metabolic response in one, and progressive metabolic disease in two patients. The prescribed dose of more than 3000 cGy10 was significantly greater in the treatment control group (P = 0.024). In binary logistic regression analysis predicting reductions in the SUVmax of more than 70% after radiotherapy, the pretreatment SUVmax (≥ 7.5) and further chemotherapy after radiotherapy showed significant differences in univariate and multivariate analyses.

CONCLUSION

Good metabolic responses (complete or partial) to radiotherapy were achieved in 92.6% of the myeloid sarcoma patients. Radiation doses < 3000 cGy10 and increased SUVmax were related to treatment failure and high SUVmax before radiotherapy was a factor influencing SUVmax reduction. Further large-scale studies are needed.

摘要

目的

正电子发射断层扫描(PET)-CT 最近已被用于髓样肉瘤的诊断成像和放射治疗,但对于预测放射治疗反应的研究甚少。本研究旨在分析 PET-CT 变量与髓样肉瘤患者放射治疗反应之间的关系。

材料与方法

本研究纳入了接受放射治疗和放射治疗前后 PET-CT 的髓样肉瘤患者。根据欧洲癌症研究与治疗组织的 PET 反应标准评估放射治疗的反应,并用二项逻辑回归分析评估预测最大标准化摄取值(SUVmax)降低的因素。

结果

研究共纳入了 12 例患者的 27 个部位。24 例患者在放射治疗后达到完全代谢缓解,1 例患者部分代谢缓解,2 例患者代谢疾病进展。治疗对照组的处方剂量大于 3000 cGy10 的显著更高(P = 0.024)。在预测 SUVmax 降低超过 70%的二元逻辑回归分析中,治疗前 SUVmax(≥7.5)和进一步的放射治疗后化疗在单因素和多因素分析中均显示出显著差异。

结论

92.6%的髓样肉瘤患者对放射治疗有良好的代谢反应(完全或部分)。剂量 < 3000 cGy10 和 SUVmax 增加与治疗失败相关,而治疗前 SUVmax 较高是 SUVmax 降低的影响因素。需要进一步开展大规模研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbb0/8687562/eb6c04a9acc5/pone.0261550.g001.jpg

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