Hölzer T, Herholz K, Jeske J, Heiss W D
Max-Planck-Institut für neurologische Forschung und Neurologische Universitätsklinik, Köln, Germany.
J Comput Assist Tomogr. 1993 Sep-Oct;17(5):681-7. doi: 10.1097/00004728-199309000-00002.
We performed a prospective cohort study in a homogeneous patient group with proven glioblastoma who received uniform therapy to determine the prognostic value and clinical correlates of [18F]fluorodeoxyglucose (FDG) PET at different stages of the disease.
Fifteen newly diagnosed patients with glioblastoma, aged 52 +/- 9 years and with Karnofsky performance score (KPS) of at least 50, were treated with surgical resection, chemotherapy (nimustine), and radiotherapy. They were followed prospectively for 2 years. Clinical data (e.g., tumor progression, performance status, and survival) were recorded and glucose metabolism was measured with PET and FDG before and during radiochemotherapy.
Median survival of all patients was 13 months and four patients were alive 24 months after surgery. All tumors were hypermetabolic compared with normal white matter. A metabolic index was calculated as the ratio of maximum residual tumor metabolism to contralateral normal brain metabolism. It was of prognostic value for patient survival and tumor recurrence already in the first postoperative and all following PET studies and was correlated with the KPS. Reduction of contralateral brain metabolism was more closely related to prognosis than the tumor metabolism proper.
These results underscore the prognostic relevance of metabolically active residual tumor tissue after surgical resection.
我们在一组经证实患有胶质母细胞瘤且接受统一治疗的同质患者中进行了一项前瞻性队列研究，以确定[18F]氟脱氧葡萄糖（FDG）PET在疾病不同阶段的预后价值及临床相关性。
15例新诊断的胶质母细胞瘤患者，年龄52±9岁，卡诺夫斯基表现评分（KPS）至少为50，接受了手术切除、化疗（尼莫司汀）和放疗。对他们进行了为期2年的前瞻性随访。记录临床数据（如肿瘤进展、表现状态和生存情况），并在放化疗前及放化疗期间用PET和FDG测量葡萄糖代谢。
所有患者的中位生存期为13个月，4例患者术后24个月仍存活。与正常白质相比，所有肿瘤均为高代谢。计算代谢指数，即最大残留肿瘤代谢与对侧正常脑代谢的比值。在首次术后及随后所有的PET研究中，它对患者生存和肿瘤复发均具有预后价值，且与KPS相关。对侧脑代谢的降低与预后的关系比肿瘤本身的代谢更为密切。
这些结果强调了手术切除后代谢活跃的残留肿瘤组织的预后相关性。
