18 F-FLT PET/CT对食管鳞癌放化疗效果预测研究

doi:10.19401/j.cnki.1007-3639.2019.12.008

中国癌症杂志 ›› 2019, Vol. 29 ›› Issue (12): 965-970.doi: 10.19401/j.cnki.1007-3639.2019.12.008

¹⁸ F-FLT PET/CT对食管鳞癌放化疗效果预测研究

任文佳¹ ，周　敏 ² ，吴式琇 ³，陈俊强⁴，陈亚楠⁵ ，陈维维⁶ ，艾沓杉¹ ，陈　贇¹ ，蒋国梁 ¹ ，赵快乐 ¹

1. 复旦大学附属肿瘤医院放疗中心，复旦大学上海医学院肿瘤学系，上海 200032 ；
2. 复旦大学附属肿瘤医院核医学中心，复旦大学上海医学院肿瘤学系，上海 200032 ；
3. 中国医学科学院肿瘤医院深圳医院放疗科，广东深圳 518117 ；
4. 福建省肿瘤医院放疗科，福建福州 350014 ；
5. 张家港第一人民医院，苏州大学附属张家港市医院，江苏张家港 215600 ；
6. 盐城市第三人民医院，南通大学第六附属医院，东南大学附属医院，江苏盐城 224001

出版日期:2019-12-30 发布日期:2020-01-08
通信作者: 赵快乐 E-mail：kuaile_z@sina.com
基金资助:
卫生部部属医院临床学科重点项目（基于肿瘤和正常组织生物信息的个体化放疗研究）。

Prognostic and predictive value of ¹⁸F-FLT PET/CT in patients with esophageal squamous carcinoma treated by radiochemotherapy

REN Wenjia¹ , ZHOU Min ² , WU Shixiu ³ , CHEN Junqiang ⁴ , CHEN Yanan ⁵ , CHEN Weiwei ⁶ , AI Tashan ¹ , CHEN Yun ¹ , JIANG Guoliang¹ , ZHAO Kuaile ¹

1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China;2. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3. Department of Radiation Oncology, Shenzhen Hospital of Cancer Hospital of Chinese Academy of Medical Sciences, Shenzhen 518117, Guangdong Province, China; 4. Department of Radiation Oncology, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China; 5. Department of Radiation Oncology, Zhangjiagang 1st People’s Hospital, Zhangjiagang Hospital Affiliated to Soochow University, Zhangjiagang 215600, Jiangsu Province, China; 6. Department of Radiation Oncology, the 6th Hospital Affiliated to Nantong University, the Affiliated Hospital of Southeast University, Yancheng 224001, Jiangsu Province, China

Published:2019-12-30 Online:2020-01-08
Contact: ZHAO Kuaile E-mail: kuaile_z@sina.com

摘要/Abstract

摘要： 背景与目的： ¹⁸ F-FLT是一种细胞增殖的示踪剂。探索 ¹⁸ F-FLT PET/CT对食管鳞癌根治性放（化）疗效果的预测价值。方法：对根治性放（化）疗的初治食管鳞癌患者，放疗前及放疗第4周行 ¹⁸ F-FLT PET/CT扫描，记录原发灶的SUV _max-T 、转移淋巴结的SUV _max-N 等参数。随访患者总生存期（overall survival，OS）及无进展生存期（progression-free survival，PFS），分析PET/CT参数与患者预后的关系。结果：共入组39例患者，25例完成2次PET/CT扫描。 ¹⁸ F-FLT的SUV_max-T 由基线6.63下降到1.22，淋巴结SUV_max-N 由3.69下降到1.84，但下比例与生存率无关。¹⁸ F-FLT PET/CT的基线SUV _max-N ＜5.00的患者，其OS明显高于SUV _max-N ≥5.00的患者（P=0.002）。结论：对根治性放（化）疗食管鳞癌，治疗前的基线 ¹⁸ F-FLT PET/CT的淋巴结SUV_max-N 是一个较好的预测预后参数。放疗4周时，病灶在 ¹⁸ F-FLT PET/CT扫描中的SUV值明显下降，但不能预测预后。

关键词: ¹⁸ F-FLT PET/CT, 食管鳞癌, 放化疗, 生存时间

Abstract: Background and purpose: ¹⁸F-FLT is a proliferative radiotracer. This study aimed to evaluate the prognostic value of functional molecular image of ¹⁸ F-FLT PET/CT taken before and in the process of radiotherapy. Methods: Patients with newly diagnosed esophageal squamous cell carcinoma (ESCC) were enrolled in the study. All patients received radiotherapy/chemoradiotherapy. The planned dose was 61.2 Gy and 1.8 Gy per fraction respectively. The concurrent chemotherapy was platinum, paclitaxel or fluoropyrimidine based. Patients were examined by PET with ¹⁸ F-fluoro-30-deoxy-30-L-fluorothymidine (FLT) at baseline and 4 weeks after treatment initiation. The overall survival (OS) and progression-free survival (PFS) were followed up. The SUV maximum (SUV _max) of primary tumor and positive nodes were recorded. PET/CT findings were analyzed for the correlation with clinical response of patients and survival. Results: Thirty-nine patients were enrolled in the study, among whom 25 patients completed two planned PET/CT. Patients with SUV max-N ≥5.00 had worse OS (P=0.002) and PFS (P=0.01) than those with SUV _max-N <5.00. The SUV _maxof both primary tumor and lymph nodes significantly decreased in the interim scan compared to the baseline scan in FLT PET/CT, but the relationship between the change of SUV _max and prognosis seemed to be weak. Conclusion: Baseline SUV _max of lymph node on ¹⁸ F-FLT PET/CT had prognostic value in patients with esophageal cancer undergoing radiotherapy/radiochemotherapy. The decrease of SUV _max of tumor after 4 weeks’ radiotherapy couldn’t predict prognosis properly.

Key words: ¹⁸ F-FLT PET/CT, Esophageal squamous cell cancer, Radiochemotherapy, Survival

任文佳, 周　敏, 吴式琇, 陈俊强, 陈亚楠, 陈维维, 艾沓杉, 陈　贇, 蒋国梁, 赵快乐 . ¹⁸ F-FLT PET/CT对食管鳞癌放化疗效果预测研究[J]. 中国癌症杂志, 2019, 29(12): 965-970.

REN Wenjia , ZHOU Min , WU Shixiu , CHEN Junqiang , CHEN Yanan , CHEN Weiwei , AI Tashan , CHEN Yun , JIANG Guoliang , ZHAO Kuaile . Prognostic and predictive value of ¹⁸F-FLT PET/CT in patients with esophageal squamous carcinoma treated by radiochemotherapy[J]. China Oncology, 2019, 29(12): 965-970.

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¹⁸ F-FLT PET/CT对食管鳞癌放化疗效果预测研究

Prognostic and predictive value of ¹⁸F-FLT PET/CT in patients with esophageal squamous carcinoma treated by radiochemotherapy

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