Hu Xinying, Han Chao, Zhang Mingquan, Jia Jing, Mu Zhengshuai, Fu Zheng, Qiao Kailin, Yu Jinming, Wei Yuchun
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong Provincial Key Laboratory of Precision Oncology, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
BMC Cancer. 2025 May 12;25(1):854. doi: 10.1186/s12885-025-14236-3.
This prospective study examined whether F-AlF-NOTA-fibroblast activation protein inhibitor (FAPI)-04 (denoted as F-FAPI-04) positron emission tomography/computed tomography (PET/CT) can detect the development and severity of radiation esophagitis (RE) in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) treated with concurrent chemoradiotherapy.
From June 2021 to March 2022, images were collected from LA-ESCC patients who underwent F-FAPI-04 PET/CT examinations before and during radiotherapy. The development of RE was evaluated weekly according to Radiation Therapy Oncology Group criterion. The target-to-background ratio in blood (TBR) was analyzed at each time point and correlated with the onset and severity of RE. Factors that predicted RE were identified by multivariate logistic analyses.
Thirty patients were evaluated. Significantly higher TBR (during radiotherapy, P = 0.003) and change in TBR compared with pre-RT (ΔTBR, P = 0.002) were observed in patients with RE than patients without RE. Those with grade 3 RE had a significantly higher TBR (during radiotherapy, P = 0.003) and ΔTBR (P = 0.003) compared with those with RE < grade 3. On multivariate analysis, ΔTBR was identified as a significant detection of any grade RE (P = 0.021) and grade 3 RE (P = 0.038).
The ΔTBR on F-FAPI-04 PET/CT may be effective at identifying patients with RE, especially grade 3 RE.
本前瞻性研究探讨了氟代铝-氮杂环三胺-成纤维细胞活化蛋白抑制剂（FAPI）-04（记为F-FAPI-04）正电子发射断层扫描/计算机断层扫描（PET/CT）能否检测接受同步放化疗的局部晚期食管鳞状细胞癌（LA-ESCC）患者放射性食管炎（RE）的发生及严重程度。
2021年6月至2022年3月，收集LA-ESCC患者放疗前及放疗期间接受F-FAPI-04 PET/CT检查的图像。根据放射治疗肿瘤学组标准每周评估RE的发生情况。分析每个时间点血液中的靶本比（TBR），并将其与RE的发生及严重程度相关联。通过多因素逻辑分析确定预测RE的因素。
评估了30例患者。与无RE的患者相比，RE患者放疗期间的TBR显著更高（P = 0.003），且与放疗前相比TBR变化（ΔTBR，P = 0.002）更大。3级RE患者的TBR（放疗期间，P = 0.003）和ΔTBR（P = 0.003）显著高于RE＜3级的患者。多因素分析显示，ΔTBR是任何级别的RE（P = 0.021）和3级RE（P = 0.038）的显著检测指标。
F-FAPI-04 PET/CT上的ΔTBR可能有助于识别RE患者，尤其是3级RE患者。
