Feasibility study of finalizing the extended adjuvant temozolomide based on methionine positron emission tomography (Met-PET) findings in patients with glioblastoma
Feasibility study of finalizing the extended adjuvant temozolomide based on methionine positron emission tomography (Met-PET) findings in patients with glioblastoma
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DOI：
10.1038/s41598-019-54398-2
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发表时间：
2019-11-28
影响因子：
4.6
通讯作者：
Iuchi, Toshihiko
中科院分区：
文献类型：
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作者：
Hirono, Seiichiro;Hasegawa, Yuzo;Iuchi, Toshihiko
在新诊断的胶质母细胞瘤患者的治疗中，替莫唑胺辅助治疗没有标准的持续时间。本研究旨在评估基于蛋氨酸正电子发射断层扫描（Met-PET）中蛋氨酸摄取的替莫唑胺辅助治疗的可行性。我们对胶质母细胞瘤患者进行了回顾性研究，这些患者在切除后接受了超过12个周期的替莫唑胺（延长替莫唑胺）治疗，同时进行了放化疗，MRI显示没有复发的迹象。除了延长替莫唑胺完成时的蛋氨酸摄取值外，还分析了局部和远处复发以及无进展生存期。44例患者完成了替莫唑胺延长治疗。其中，18人在一年内经历了某种类型的肿瘤复发。Tmax/Nave值为2.0是表示进展的最佳临界值。超过80%的低蛋氨酸摄取患者完成了替莫唑胺治疗，随后的基本MRI观察显示Met-PET后一年内无复发。高吸收量亚组（>= 2.0），即使继续替莫唑胺治疗，肿瘤进展也比低吸收量亚组(
In the management of patients with newly diagnosed glioblastoma, there is no standard duration for adjuvant temozolomide treatment. This study aimed to assess the feasibility of finalizing adjuvant temozolomide treatment on the basis of methionine uptake in methionine positron emission tomography (Met-PET). We conducted a retrospective review of glioblastoma patients who underwent more than twelve cycles of temozolomide (extended temozolomide) treatment after resection and concomitant chemoradiotherapy with no evidence of recurrence on MRI. In addition to the methionine uptake value at the completion of extended temozolomide, local and distant recurrence and progression-free survival were also analyzed. Forty-four patients completed the extended temozolomide treatment. Among these, 18 experienced some type of tumor recurrence within one year. A Tmax/Nave value of 2.0 was the optimal cut-off value indicating progression. More than 80% of the patients with low methionine uptake completed the temozolomide treatment, and subsequent basic MRI observations showed no recurrence within one year after Met-PET. Subgroups with high uptake (>= 2.0), even with continuation of temozolomide treatment, showed more frequent tumor progression than patients with low uptake (