Kim Mai, Ogawa Masaru, Suzuki Keisuke, Tokue Azusa, Higuchi Tetsuya, Tsushima Yoshito, Yokoo Satoshi
Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan.
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan.
Oral Radiol. 2025 Sep 2. doi: 10.1007/s11282-025-00856-9.
The present study examined the efficacy of the F-FDG PET/CT (18F-FDG PET)-based Lugano Classification for Oral Cancer (Lugano-OC) to stage treatment-resistant oral cancer and its utility for predicting treatment responses.
We included 29 oral squamous cell carcinoma (OSCC) patients with disease progression post the primary treatment, who had F-FDG PET scans prior to secondary treatment initiation, and were evaluable via Lugano-OC between April 2013 and September 2022. To adapt Lugano-OC to the head and neck region, we designated the clavicle level, a regional lymph node in oral cancer, as the reference standard and visually evaluated 18F-FDG PET accumulation patterns. The primary endpoint was the best overall response, which was assessed according to the Response Evaluation Criteria in Solid Tumors.
Patients were categorized into a responder group (n = 7) and non-responder group (n = 22). A univariate analysis revealed significant differences in the CT maximum diameter and metabolic tumor volume (p = 0.050, and 0.037, respectively). A multivariate Cox regression analysis revealed a correlation (hazard ratio 3.59, p = 0.046, 95% confidence interval 1.02-12.6) between Lugano-OC and the duration of treatment responses.
Among OSCC patients with disease progression post the primary treatment, those with Lugano-OC-localized disease who received radiation chemotherapy had a significantly longer treatment response than patients with advanced-stage disease. These results suggest the predictive value of Lugano-OC for assessing treatment responses in this patient population.
本研究探讨基于氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）的口腔癌卢加诺分类（Lugano-OC）对治疗抵抗性口腔癌进行分期的疗效及其预测治疗反应的效用。
我们纳入了29例口腔鳞状细胞癌（OSCC）患者，这些患者在初次治疗后疾病进展，在二次治疗开始前进行了F-FDG PET扫描，并且在2013年4月至2022年9月期间可通过Lugano-OC进行评估。为使Lugano-OC适用于头颈部区域，我们将口腔癌区域淋巴结锁骨水平指定为参考标准，并对18F-FDG PET的积聚模式进行视觉评估。主要终点是最佳总体反应，根据实体瘤疗效评价标准进行评估。
患者分为反应者组（n = 7）和无反应者组（n = 22）。单因素分析显示CT最大直径和代谢肿瘤体积存在显著差异（分别为p = 0.050和0.037）。多因素Cox回归分析显示Lugano-OC与治疗反应持续时间之间存在相关性（风险比3.59，p = 0.046，95%置信区间1.02 - 12.6）。
在初次治疗后疾病进展的OSCC患者中，接受放化疗的Lugano-OC局限性疾病患者的治疗反应明显长于晚期疾病患者。这些结果表明Lugano-OC在评估该患者群体治疗反应方面具有预测价值。
