中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (3): 225-230.doi: 10.3969/j.issn.1007-3969.2014.03.012

• 论著 • 上一篇    下一篇

PET/CT标准摄取值与Ⅲ期非小细胞肺癌西妥昔单抗联合同期放化疗预后相关性的研究

刘笛1,陈佳艳1,2,沈钰新1,赵伟新1,傅小龙1,蒋国樑1,樊旼1   

  1. 1.复旦大学附属肿瘤医院放疗科,复旦大学上海医学院肿瘤学系,上海200032 ;
    2.南京医科大学附属南京第一医院放疗科,江苏 南京 210006
  • 出版日期:2014-03-31 发布日期:2014-04-01
  • 通信作者: 樊旼 E-mail:fanming@fudan.edu.cn
  • 基金资助:
    卫生部临床学科重点项目(No:卫规财函[2010]439号)

Prognostic value of SUVmax for locally advanced non-small cell lung cancer patients treated with synchronous cetuximab plus concurrent chemoradiotherapy

LIU Di1, CHEN Jia-yan1,2, SHEN Yu-xin1, ZHAO Wei-xin1, FU Xiao-long1, JIANG Guo-liang1, FAN Min1   

  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 Radiation Oncology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing Jiangsu 210006, China
  • Published:2014-03-31 Online:2014-04-01
  • Contact: FAN Min E-mail: fanming@fudan.edu.cn

摘要:

背景与目的:PET/CT在非小细胞肺癌(non-small cell lung cancerNSCLC)的预后判断中有重要价值,但单独针对Ⅲ期且接受靶向治疗患者的研究较少。本研究旨在探讨在这些患者中18F氟代脱氧葡萄糖(18F-fluorodeoxyghcose18F-FDG)PET/CT基线标准摄取值(standard uptake valueSUV)与预后的相关性。方法:前瞻性分析复旦大学附属肿瘤医院放疗科20099月—20127月入组的17例接受西妥昔单抗(cetuximabC225)联合顺铂+长春瑞宾(NP方案)诱导化疗及同期放化疗的患者,入组前两周内完成PET/CT检查。采用Cox回归风险比例模型对SUV-TSUV-NSUV-TOTAL、性别、年龄、组织学类型、TNM分期、功能状态评分(performance statusPS)、吸烟状态与患者生存时间进行单因素生存分析,差异有统计学意义者进行多因素生存分析。Log-rank检验及Kaplan-Meier法分别评估以SUV-TSUV-NSUV-TOTAL界值分组患者间生存期的差异并绘制生存曲线。结果:单因素预后分析提示,上述SUVmaxPS评分、吸烟状态与预后相关,其中SUV-TSUV-N的界值是11SUV-TOTAL20。多因素分析结果显示,SUV-TOTAL(P=0.012)SUV-T(P=0.025)SUVN(P=0.033)是影响本组患者生存的独立预后因素,其中SUV-TOTAL>20组患者的相对危险度(hazard ratioHR)14.7结论:对于C225联合同步放化疗的患者,PET/CT局部区域、原发灶及纵隔淋巴结SUV值与预后有一定相关性,值得进一步大样本研究。将3者结合起来,可指导该治疗的合理应用。

关键词: 非小细胞肺癌, PET/CT, 标准摄取值, 预后

Abstract:

Background and purpose: We investigated whether fluorine-18 fluorodeoxyglucose (18F-FDG) maximal standard uptake value (SUVmax) of the primary tumor (SUV-T), SUVmax of the regional lymph nodes (SUV-N) or the overall loco-regional lesion SUVmax (SUV-TOTAL) was related to survival of patients with stage nonsmall cell lung cancer (NSCLC) who received Cetuximab and combined definitive chemoradiotherpay. Methods: From September 2009 to July 2012, seventeen patients with unresectable stage NSCLC receiving cetuximab with cisplatin/vinorelbine (NP) followed by concomitant NP and intensity-modulated radiotherapy (IMRT) at the Fudan University Shanghai Cancer Center were enrolled onto a prospectively study. All patients received positron emission tomography/computerized tomography (PET/CT) scans within 2 weeks before enrolment. Univariate analysis were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumour-node-metastasis (TNM) stage, performance status (PS) as well as smoking status and survival. The factors which showed statistical significance entered into multivariate Cox-regression model. Survival functions of different populations were estimated by Kaplan-Meier method and compared by Log-rank test. Results: In the univariate analysis, SUV-T, SUV-N, SUVTOTAL, PS and smoking status were prognostic factors. The best cut-off values for SUV-T, SUV-N and SUV-TOTAL were 11, 11 and 20, respectively. Multivariate analysis revealed that SUV-TOTAL (P=0.012), SUV-T (P=0.025), and SUV-N (P=0.033) were independent predictors of survival with hazard ratio (HR) of 14.7, 11.2, and 6.2, respectively. Conclusion: Local, regional and locoregional maximal SUVs defined by 18F-FDG PET-CT scanning may have a strong correlation with survival in this patients setting, which merits further study.

Key words: Non-small cell lung cancer, PET/CT, Standardized uptake values, Prognosis