Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China.
Department of Training Education, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China.
BMC Med Imaging. 2023 Aug 15;23(1):107. doi: 10.1186/s12880-023-01067-6.
To assess the predictive values of primary tumor FDG uptake for patients with inoperable stage III non-small cell lung cancer (NSCLC) after concurrent chemoradiotherapy (CCRT).
A total of 107 patients with diagnosis of stage III NSCLC and CCRT were enrolled. The tumor maximum uptake value (SUVmax) was standardized by calculating several ratios between tumor and each background tissues. The receiver operating characteristics curve (ROC) was used to compare the predictive power of prognostic models. The tumor objective response rate (ORR) and overall survival (OS) were compared and analyzed by the Kaplan-Meier method and univariate and multivariate Cox regression models.
The areas under ROC curve (AUCs) ranged from 0.72 to 0.81 among these tumor SUVmax and standardized SUVmax ratios, and the tumor SUVmax and tumor SUVmax-to-liver SUVmean ratio (TLMR) were more predictive of ORR (AUC, 0.81; 95% CI, 0.73-0.88 for tumor SUVmax and AUC, 0.84; 95%CI, 0.76-0.91 for TLMR) than any of other SUVmax ratios. The patients with lower tumor SUVmax, SUVmean and SUVmax ratios had a significantly better OS than those with their corresponding higher ones. Moreover, both univariate and multivariable analyses revealed that TLMR was significantly associated with better ORR and OS after adjustment with other prognostic variables.
TLMR, a standardized tumor SUVmax, was an independent prognostic predictor for tumor ORR and OS of patients with stage III NSCLC after CCRT.
评估同期放化疗后不可手术的 III 期非小细胞肺癌（NSCLC）患者原发肿瘤 FDG 摄取对预后的预测价值。
共纳入 107 例 III 期 NSCLC 患者接受同期放化疗。通过计算肿瘤与每种背景组织之间的多个比值，对肿瘤最大摄取值（SUVmax）进行标准化。使用受试者工作特征曲线（ROC）比较预后模型的预测能力。通过 Kaplan-Meier 方法和单因素及多因素 Cox 回归模型比较和分析肿瘤客观缓解率（ORR）和总生存期（OS）。
在这些肿瘤 SUVmax 和标准化 SUVmax 比值中，ROC 曲线下面积（AUCs）范围为 0.72 至 0.81，肿瘤 SUVmax 和肿瘤 SUVmax 与肝 SUVmean 比值（TLMR）对 ORR 的预测性更高（AUC，0.81；95%CI，0.73-0.88 用于肿瘤 SUVmax 和 AUC，0.84；95%CI，0.76-0.91 用于 TLMR），优于任何其他 SUVmax 比值。肿瘤 SUVmax、SUVmean 和 SUVmax 比值较低的患者 OS 明显优于相应比值较高的患者。此外，单因素和多因素分析均显示，TLMR 是与 CCRT 后 III 期 NSCLC 患者 ORR 和 OS 显著相关的独立预后因素。
TLMR，一种标准化的肿瘤 SUVmax，是同期放化疗后 III 期 NSCLC 患者肿瘤 ORR 和 OS 的独立预后预测指标。
