Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501 Japan.
Hell J Nucl Med. 2022 May-Aug;25(2):155-162. doi: 10.1967/s002449912476. Epub 2022 Aug 3.
This study was conducted to evaluate the usefulness of early assessment of tumor response using fluorine-18-fludeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) after one cycle of systemic therapy in patients with recurrent and metastatic breast cancer.
Thirty-three patients with recurrent or metastatic breast cancer underwent F-FDG PET/CT before and after one cycle of systemic therapy. Based on the European Organization for Research and Treatment of Cancer (EORTC) criteria, the maximum standardized uptake value (SUVmax) of the same lesions (up to a total of five) noted in the baseline and follow-up scans were summed (maximum of two per organ) as target lesions, and therapeutic response was evaluated. Log-rank and Cox methods were employed to determine progression-free survival (PFS) and overall survival (OS).
Complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD) was seen in 2, 16, 11, and 4 patients, respectively. The mean reduction rates of SUVmax between 84 target lesions in 18 responders (CMR/PMR) and 75 target lesions in 15 non-responders (SMD/PMD) were -55.8% (range, -100%- -1.2%) and 0.47% (range, -48.7%- +209.4%), respectively, with a significant difference (P<0.0001). Every lesion site (local lesion, lymph node metastasis, bone metastasis, lung metastasis, and liver metastasis) showed a similar tendency. Thirty patients showed progression, and 17 died due to breast cancer after a median of 38.5 months. Responders showed significantly longer PFS than non-responders (P=0.0038).
Fluorine-18-FDG PET/CT after one cycle of systemic therapy was able to reflect early metabolic changes regardless of the lesion site, and showed accuracy for early response evaluation and prediction of progression in patients with recurrent or metastatic breast cancer.
本研究旨在评估氟-18-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）在复发转移性乳腺癌患者接受一周期系统治疗后早期评估肿瘤反应的作用。
33 例复发或转移性乳腺癌患者在接受一周期系统治疗前后进行 F-FDG PET/CT 检查。根据欧洲癌症研究与治疗组织（EORTC）标准，将基线和随访扫描中相同病变（最多 5 个）的最大标准化摄取值（SUVmax）相加（每个器官最多 2 个）作为靶病变，并进行疗效评价。采用对数秩和 Cox 法分析无进展生存期（PFS）和总生存期（OS）。
2 例患者达到完全代谢缓解（CMR），16 例达到部分代谢缓解（PMR），11 例达到稳定代谢疾病（SMD），4 例达到进展性代谢疾病（PMD）。18 例（CMR/PMR）有效患者的 84 个靶病变和 15 例（SMD/PMD）无效患者的 75 个靶病变 SUVmax 平均下降率分别为-55.8%（范围：-100%至-1.2%）和 0.47%（范围：-48.7%至+209.4%），差异有统计学意义（P<0.0001）。每个病变部位（局部病变、淋巴结转移、骨转移、肺转移和肝转移）均表现出类似的趋势。30 例患者出现进展，17 例患者在中位随访 38.5 个月后死于乳腺癌。有效组的 PFS 明显长于无效组（P=0.0038）。
在接受一周期系统治疗后进行 F-FDG PET/CT 检查可以反映早期的代谢变化，无论病变部位如何，都能准确评估复发或转移性乳腺癌患者的早期疗效和预测进展。
