The role of<sup>99m</sup>Tc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma

杜承润; 应红梅; 程竞仪; 周珺珺; 蒋津津; 王孝深; 胡超苏

doi:10.3969/j.issn.1007-3969.2013.10.009

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The role of^99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma

更新时间：2025-12-31

- The role of^99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma
- China Oncology Vol. 23, Issue 10, Pages: 834-840(2013)
- 作者机构：
  
  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. 复旦大学附属肿瘤医院核医学科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2013.10.009
  CLC：
- Published Online：19 February 2014，
  
  Published：19 February 2013
- 稿件说明：
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杜承润,应红梅,程竞仪,周珺珺,蒋津津,王孝深,胡超苏. 双时相

杜承润, 应红梅, 程竞仪, et al. The role of^99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma[J]. China Oncology, 2013, 23(10): 834-840.
杜承润,应红梅,程竞仪,周珺珺,蒋津津,王孝深,胡超苏. 双时相 DOI： 10.3969/j.issn.1007-3969.2013.10.009.

杜承润, 应红梅, 程竞仪, et al. The role of^99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma[J]. China Oncology, 2013, 23(10): 834-840. DOI： 10.3969/j.issn.1007-3969.2013.10.009.

摘要

背景与目的：在局部晚期鼻咽癌的治疗中，含多西他赛新辅助化疗正得到广泛的应用，其可能进一步提高局部晚期鼻咽癌的生存率。如果能在化疗前预测鼻咽癌对含多西他赛新辅助化疗的敏感性，将有助于更合理地为鼻咽癌患者制定个体化的治疗方案。前期研究发现，

99m

Tc-MIBI显像能够预测鼻咽癌对经典的顺铂联合5-氟脲嘧啶(5-FU)的化疗敏感性，但

99m

Tc-MIBI显像对含多西他赛方案化疗敏感性的预测价值有待进一步探讨。本研究的目的是探讨双时相

99m

Tc-MIBI SPECT/CT显像预测局部晚期鼻咽癌对含多西他赛新辅助化疗敏感性的价值。方法：31例局部晚期鼻咽癌患者，分别于注射

99m

Tc-MIBI后即刻和2 h后进行早期和晚期

99m

Tc-MIBISPECT/CT显像。所有患者行2个疗程TPF方案(多西他赛+顺铂+5-FU)新辅助化疗。分析

99m

Tc-MIBI SPECT/CT显像中早期摄取率、晚期摄取率和清除率与新辅助化疗的疗效关系。结果：根据磁共振评价新辅助化疗疗效，化疗高反应病灶的早期摄取率为2.67±0.83，而化疗低反应病灶的早期摄取率为1.69±0.46，差异有统计学意义(P=0.003)；晚期摄取率分别为1.46±0.39和1.06±0.62，差异有统计学意义(P=0.026)。清除率在化疗高反应病灶(44.9%±13.9%)和化疗低反应病灶(35.5%±30.5%)之间的差异无统计学意义(P=0.23)。ROC曲线分析，早期摄取率AUC=0.84，最佳诊断界点为1.97，其灵敏度为74.2%，特异度为87.5%，阳性预测值为95.8%，阴性预测值为46.7%，准确率为76.9%。结论：

99m

Tc-MIBI SPECT/CT显像早期摄取率和晚期摄取率能够预测局部晚期鼻咽癌对含多西他赛方案新辅助化疗的敏感性。

Abstract

Background and purpose: Neoadjuvant chemotherapy with docetaxel was gaining more attention in the treatment for locoregionally advanced nasopharyngeal carcinoma (NPC). The prediction of the sensitivity to neoadjuvant chemotherapy with docetaxel could enable c

linicians to individualize treatment protocols for NPC. Recently we found that

99m

Tc-MIBI imaging in NPC could predict tumor response to chemotherapy with cisplatin plus 5-FU. However

there was no study to support similar findings in NPC patients receiving chemotherapy containing docetaxel. This study was to evaluate the value of double-phase

99m

Tc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for nasopharyngeal carcinoma. Methods: Thirty-one nasopharyngeal carcinoma patients participated in this prospective study. Before treatment

early and delayed singlephoton emission computed tomography/compute tomography (SPECT/CT) images were obtained instantly and 2 hours after an intravenous injection of 25-30 mCi

99m

Tc-MIBI. All patients received neoadjuvant chemotherapy consisting of docetaxel

cisplatin plus 5-FU for two cycles. The relationships between efficacy of neoadjuvant chemotherapy and the early uptake ratio

late uptake ratio and washout rate of

99m

Tc-MIBI were evaluated. Results: According to the MRI

the early uptake of

99m

Tc-MIBI (2.67±0.83) in the lesions which were sensitive to chemotherapy was significantly higher compared with that (1.69±0.46) in the insensitive lesions(P=0.003). The difference of the late uptake between the sensitive(1.46±0.39) and the insensitive (1.06±0.62) was also statistically significant (P=0.026). However

the washout rate of

99m

Tc-MIBI was not significantly different between the two groups (P=0.23). Through ROC curve analysis

the AUC for early uptake of

99m

Tc-MIBI and late uptake were 0.84. The sensitivity

specificity

positive predictive value and negative predictive value were 74.2%

87.5%

95.8% and 46.7% for early uptake when the cut off value of 1.97 was used. Conclusion: The uptake of 99mTc-MIBI in both early phase and late phase could predict the efficacy of neoadjuvant chemotherapy with docetaxel-based regimen.

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The role of99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma

DOI：10.3969/j.issn.1007-3969.2013.10.009

摘要

Abstract

关键词

Keywords

references

The role of^99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for locoregionally advanced nasopharyngeal carcinoma