Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Department of Radiation Oncology, Shandong University Cancer Center, Jinan, China.
Front Immunol. 2022 Oct 21;13:1004351. doi: 10.3389/fimmu.2022.1004351. eCollection 2022.
The purpose of this study was to investigate the predictive value of tumor metabolic parameters in combination with secondary lymphoid metabolic parameters on positron emission tomography (PET)/computed tomography (CT) for immune checkpoint inhibitor (ICI) prognosis in advanced lung cancer.
This study retrospectively included 125 patients who underwent 18F-fludeoxyglucose (FDG) PET/CT before ICI therapy, including 41 patients who underwent a second PET/CT scan during ICI treatment. The measured PET/CT parameters included tumor metabolism parameters [maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), total lesion glycolysis (TLG), and total metabolic tumor volume (TMTV)] and secondary lymphoid organ metabolism parameters [spleen-to-liver SUVmax ratio (SLR) and bone marrow-to-liver SUVmax ratio (BLR)]. The correlation of PET/CT metabolic parameters with early ICI treatment response, progression-free survival (PFS), and overall survival (OS) was analyzed.
Within a median follow-up of 28.7 months, there were 44 responders and 81 non-responders. The median PFS was 8.6 months (95% confidence interval (CI): 5.872-11.328), and the median OS was 20.4 months (95% CI: 15.526-25.274). Pretreatment tumor metabolic parameters were not associated with early treatment responses. The high bone marrow metabolism (BLR >1.03) was significantly associated with a shorter PFS (p = 0.008). Patients with a high TMTV (>168 mL) and high spleen metabolism (SLR >1.08) had poor OS (p = 0.019 and p = 0.018, respectively). Among the 41 patients who underwent a second PET/CT scan, the ΔSUVmax was significantly lower (p = 0.01) and the SLR was significantly higher (p = 0.0086) in the responders. Populations with low-risk characteristics (low TMTV, low SLR, and ΔSLR > 0) had the longest survival times.
High pretreatment TMTV and SLR are associated with poor OS, and increased spleen metabolism after ICI therapy predicts treatment benefit. This indicates that the combination of tumor and spleen metabolic parameters is a valuable prognostic strategy.
本研究旨在探讨肿瘤代谢参数与继发淋巴器官代谢参数联合在正电子发射断层扫描（PET）/计算机断层扫描（CT）预测免疫检查点抑制剂（ICI）治疗晚期肺癌中的预后价值。
本研究回顾性纳入 125 例接受 ICI 治疗前 18F-氟脱氧葡萄糖（FDG）PET/CT 的患者，其中 41 例患者在 ICI 治疗期间接受了第二次 PET/CT 扫描。所测量的 PET/CT 参数包括肿瘤代谢参数[最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）、总病灶糖酵解（TLG）和总代谢肿瘤体积（TMTV）]和继发淋巴器官代谢参数[脾脏与肝脏 SUVmax 比值（SLR）和骨髓与肝脏 SUVmax 比值（BLR）]。分析了 PET/CT 代谢参数与早期 ICI 治疗反应、无进展生存期（PFS）和总生存期（OS）的相关性。
中位随访 28.7 个月时，有 44 例患者为应答者，81 例患者为无应答者。中位 PFS 为 8.6 个月（95%置信区间（CI）：5.872-11.328），中位 OS 为 20.4 个月（95%CI：15.526-25.274）。治疗前肿瘤代谢参数与早期治疗反应无关。高骨髓代谢（BLR >1.03）与较短的 PFS 显著相关（p=0.008）。TMTV 较高（>168 mL）和脾脏代谢较高（SLR >1.08）的患者 OS 较差（p=0.019 和 p=0.018）。在接受第二次 PET/CT 扫描的 41 例患者中，应答者的ΔSUVmax 显著降低（p=0.01），SLR 显著升高（p=0.0086）。低风险特征（低 TMTV、低 SLR 和 ΔSLR >0）的患者具有最长的生存时间。
高预处理 TMTV 和 SLR 与较差的 OS 相关，ICI 治疗后脾脏代谢增加预示着治疗获益。这表明肿瘤和脾脏代谢参数的联合是一种有价值的预后策略。
Zotero 插件
