正电子发射断层显像/X线计算机体层成像（PET/CT）在食管癌或食管胃交界癌患者中的应用接受度与差异：基于成熟登记数据的评估

Acceptance and disparities of PET/CT use in patients with esophageal or gastro-esophageal junction cancer: Evaluation of mature registry data.

作者信息

Gupta Vaibhav, Kulanthaivelu Roshini, Metser Ur, Ortega Claudia, Darling Gail, Coburn Natalie, Veit-Haibach Patrick

机构信息

Department of Surgery, University Health Network / Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

出版信息

Front Nucl Med. 2022 Sep 16;2:917873. doi: 10.3389/fnume.2022.917873. eCollection 2022.

DOI:10.3389/fnume.2022.917873

PMID:39354957

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11440829/

Abstract

BACKGROUND/RATIONALE: PET/CT plays a crucial role in esophageal (EC) and gastroesophageal junction cancer (GEJ) diagnosis and management. Despite endorsement in clinical guidelines, variation in acceptance of PET/CT exists. The aim of this study was to assess the early use of PET/CT among EC and GEJ patients in a regionalized setting and identify factors contributing to disparity in access.

MATERIALS AND METHODS

Retrospective cohort study of adults with EC or GEJ between 2012 and 2014 from the Population Registry of Esophageal and Stomach Tumours of Ontario and Ontario Health (Cancer Care Ontario). Receipt of PET/CT and relevant demographics were collected, and statistical analysis performed. Continuous data were analysed with t-tests and Wilcoxon rank sum test. Categorical data were analysed with chi-square test. Kaplan-Meier methods were used to estimate median survival.

RESULTS

Fifty-five percent of patients diagnosed with EC or GEJ between 2012 and 2014 received PET/CT (1321/2390). Eighty-four percent of patients underwent surgical resection (729/870), and 80% receiving radical treatment (496/622) underwent PET/CT. The use of PET/CT increased from 2012 to 2014. Male patients received more PET/CT than females (85% vs.78% < 0.001).Median survival for the overall cohort was 11.1 months, 17.2 vs. 5.2 months among those who did and did not receive PET/CT and 35 vs. 27 months among the surgical cohort ( = 0.16).

CONCLUSIONS

We found that PET/CT use increased from 2012 to 2014 and that the majority of EC/GEJ patients being considered for curative therapy received PET/CT. There were also gender disparities identified. PET/CT appears to confer a potential survival benefit in our study, although our assessment is limited. Our findings may serve as learned lessons for other new imaging modalities, new indications for PET/CT or even for the introduction of new radiopharmaceuticals for PET/CT.

摘要

背景/原理：正电子发射断层显像/计算机断层扫描（PET/CT）在食管癌（EC）和胃食管交界癌（GEJ）的诊断及治疗中发挥着关键作用。尽管临床指南中对此予以认可，但PET/CT的接受程度仍存在差异。本研究旨在评估在区域化环境下EC和GEJ患者中PET/CT的早期使用情况，并确定导致获取差异的因素。

材料与方法

对2012年至2014年间来自安大略省食管和胃肿瘤人口登记处及安大略省卫生厅（安大略癌症护理机构）的成年EC或GEJ患者进行回顾性队列研究。收集PET/CT的使用情况及相关人口统计学数据，并进行统计分析。连续数据采用t检验和Wilcoxon秩和检验进行分析。分类数据采用卡方检验进行分析。采用Kaplan-Meier方法估计中位生存期。

结果

2012年至2014年间，55%被诊断为EC或GEJ的患者接受了PET/CT检查（1321/2390）。84%的患者接受了手术切除（729/870），在接受根治性治疗的患者中，80%（496/622）接受了PET/CT检查。2012年至2014年间，PET/CT的使用有所增加。男性患者接受PET/CT检查的比例高于女性（85%对78%，P<0.001）。整个队列的中位生存期为11.1个月，接受PET/CT检查和未接受PET/CT检查的患者分别为17.2个月和5.2个月，手术队列中分别为35个月和27个月（P=0.16）。

结论

我们发现2012年至2014年间PET/CT的使用有所增加，且大多数考虑进行根治性治疗的EC/GEJ患者接受了PET/CT检查。此外，还发现了性别差异。尽管我们的评估有限，但在本研究中PET/CT似乎具有潜在的生存获益。我们的研究结果可为其他新的成像模式、PET/CT的新适应证甚至PET/CT新型放射性药物的引入提供经验教训。