Zhelev Kiril, Mihaylova-Hristov Maria, Conev Nikolay, Cholakova Manoela, Korabova Bilyana, Petrov Ivaylo, Georgieva Nedyalka, Nedev Nikolay, Mihaylova Iglika, Petrova Mila, Zahariev Zahari, Donev Ivan
Department of Radiotherapy, MHAT "Heart and Brain", Pleven, Bulgaria.
Department of Nuclear Medicine, SHAT in Oncology, Sofia, Bulgaria.
Contemp Oncol (Pozn). 2023;27(4):263-268. doi: 10.5114/wo.2023.135288. Epub 2024 Feb 8.
Stereotactic body radiotherapy (SBRT) is well established for oligometastatic disease, and it is increasingly used to treat adrenal metastases.
In this retrospective study we performed an analysis of 75 metastatic adrenal lesions in 64 patients with oligometastatic disease. According to the fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) maximum standardized uptake value (SUV) of adrenal metastases, patients were categorized into three groups: low, intermediate, and high SUVmax.
For all clinicopathological characteristics we found significant relationships for levels of SUV and objective response rate (Kendall Tau-c = 0.290; = 0.017). Patients who responded to SBRT had a significantly lower SUV value than those who did not respond (7.6 ±2.4 vs. 9.7 ±3.8; = 0.015). At the appropriate SUV cut-off values, the biomarker distinguished between patients with and without a response significantly and moderately (area under the curve = 0.670, 95% confidence intervals: 0.540-0.790; = 0.015).
Lower SUVmax is associated with a better response to SBRT in patients whose disease progressed mainly in the adrenal glands.
立体定向体部放射治疗（SBRT）在寡转移疾病的治疗中已得到充分确立，并且越来越多地用于治疗肾上腺转移瘤。
在这项回顾性研究中，我们对64例寡转移疾病患者的75个转移性肾上腺病变进行了分析。根据肾上腺转移瘤的氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）最大标准化摄取值（SUV），将患者分为三组：低SUVmax、中SUVmax和高SUVmax。
对于所有临床病理特征，我们发现SUV水平与客观缓解率之间存在显著相关性（肯德尔Tau-c = 0.290；P = 0.017）。对SBRT有反应的患者的SUV值明显低于无反应的患者（7.6±2.4 vs. 9.7±3.8；P = 0.015）。在合适的SUV临界值时，该生物标志物能显著且适度地区分有反应和无反应的患者（曲线下面积 = 0.670，95%置信区间：0.540 - 0.790；P = 0.015）。
在疾病主要进展于肾上腺的患者中，较低的SUVmax与对SBRT的更好反应相关。
