氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）代谢参数在预测局部晚期宫颈癌放化疗期间血液学毒性中的作用
Role of FDG PET/CT metabolic parameters in predicting hematological toxicity during chemoradiotherapy for locally advanced cervical cancer.
作者信息
Meng Tianyu, Meng Xiangxi, Xu Xiaoxia, Li Xiaofan, Yang Zhi, Li Nan
机构信息
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital and Institute, Beijing, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China.
出版信息
Front Oncol. 2022 Aug 18;12:956652. doi: 10.3389/fonc.2022.956652. eCollection 2022.
PURPOSE
The aim of this study is to evaluate the value of FDG PET/CT metabolic parameters in predicting hematological toxicity (HT) during chemoradiotherapy (CRT) for locally advanced cervical cancer (LACC).
METHODS AND MATERIALS
Forty-one patients with LACC undergoing concurrent CRT were retrospectively analyzed. The correlations among age, body mass index, FIGO stage, differentiation, maximum diameter of primary lesion, parametrial invasion, lymph node metastasis, pelvic active bone marrow volume (BM), BM volume percentage (BM%), maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and HT were analyzed using hypothesis testing and logistic regression. A p-value< 0.05 was considered significant unless otherwise specified.
RESULTS
Among the 41 patients, 19 had grade 3-4 HT and 22 had grade 0-2 HT. Only SUVmax (Z = -1.961, p = 0.050) and BM% (χ2 = 7.769, p = 0.020) showed statistically significant difference in univariate analysis. In logistic regression, grade 3-4 HT was not associated with SUVmax. The probability of HT occurrence in<30% BM% was 0.071 times less than in 30%-40% BM% (p = 0.010, OR = 0.071, 95% CI = 0.010-0.532), and the probability of HT occurrence in >40% BM% was 0.148 times less than in 30%-40% BM% (p = 0.037, OR = 0.148, 95% CI = 0.025-0.892).
CONCLUSION
Baseline FDG PET/CT BM% could help predict the severity of HT during CRT for LACC.
目的
本研究旨在评估氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）代谢参数在预测局部晚期宫颈癌（LACC）放化疗（CRT）期间血液学毒性（HT）方面的价值。
方法与材料
回顾性分析41例接受同步CRT的LACC患者。采用假设检验和逻辑回归分析年龄、体重指数、国际妇产科联盟（FIGO）分期、分化程度、原发灶最大直径、宫旁浸润、淋巴结转移、盆腔活跃骨髓体积（BM）、BM体积百分比（BM%）、最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）和HT之间的相关性。除非另有说明，p值<0.05被认为具有统计学意义。
结果
41例患者中，19例发生3 - 4级HT，22例发生0 - 2级HT。单因素分析中，仅SUVmax（Z = -1.961，p = 0.050）和BM%（χ2 = 7.769，p = 0.020）显示出统计学显著差异。在逻辑回归中，3 - 4级HT与SUVmax无关。BM%<30%时HT发生概率比30% - 40%时低0.071倍（p = 0.010，OR = 0.071，95%可信区间[CI]=0.010 - 0.532），BM%>40%时HT发生概率比30% - 40%时低0.148倍（p = 0.037，OR = 0.148，95%CI = 0.025 - 0.892）。
结论
基线FDG PET/CT的BM%有助于预测LACC患者CRT期间HT的严重程度。
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