Triple-Negative Breast Cancer: Early Assessment with 18F-FDG PET/CT During Neoadjuvant Chemotherapy Identifies Patients Who Are Unlikely to Achieve a Pathologic Complete Response and Are at a High Risk of Early Relapse
Triple-Negative Breast Cancer: Early Assessment with 18F-FDG PET/CT During Neoadjuvant Chemotherapy Identifies Patients Who Are Unlikely to Achieve a Pathologic Complete Response and Are at a High Risk of Early Relapse
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DOI：
10.2967/jnumed.111.094045
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发表时间：
2012-02-01
影响因子：
9.3
通讯作者：
Espie, Marc
中科院分区：
文献类型：
--
作者：
Groheux, David;Hindie, Elif;Espie, Marc
三阴性乳腺癌是一种侵袭性亚型，占浸润性乳腺肿瘤的15%。这项前瞻性研究调查了新辅助化疗（NAC）期间F-18-FDG肿瘤摄取的早期变化是否可以预测结果。方法：20例（MO）患者在基线和第2个周期后接受F-18-FDG PET/CT检查。无论PET结果如何，均继续NAC治疗。结果：手术时，6例患者病理完全缓解，而14例有残留肿瘤。4例患者出现早期复发（术后2年内）。以最大标准化摄取值下降42%作为临界值，有11例代谢应答者和9例无应答者。在无应答患者中，手术时肿瘤残留的风险为100%（应答者为45%; P = 0.014），早期复发的风险为44%（应答者为0%; P = 0.024）。结论：2个周期时F-18-FDG摄取下降小于42%意味着NAC结束时肿瘤残留，早期复发风险高。
Triple-negative breast cancer, an aggressive subtype, represents 15% of invasive breast tumors. This prospective study investigated whether early changes in F-18-FDG tumor uptake during neoadjuvant chemotherapy (NAC) can predict outcomes. Methods: Twenty (MO) patients underwent F-18-FDG PET/CT at baseline and after the second cycle. NAC was continued irrespective of PET results. Results: At surgery, 6 patients had a pathologic complete response, whereas 14 had residual tumor. Four patients showed early relapse (in the 2 y after surgery). There were 11 metabolic responders and 9 nonresponders using a 42% decrease in maximum standardized uptake value as a cutoff. In nonresponding patients, the risk of residual tumor at surgery was 100% (vs. 45% in responders; P = 0.014), and the risk of early relapse was 44% (vs. 0%; P = 0.024). Conclusion: A less than 42% decrease in F-18-FDG uptake at 2 cycles means residual tumor at the end of NAC and a high risk of early relapse.