Biological tumor volume in 18FET-PET before radiochemotherapy correlates with survival in GBM
Biological tumor volume in 18FET-PET before radiochemotherapy correlates with survival in GBM
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DOI：
10.1212/wnl.0000000000001262
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发表时间：
2015-02-17
期刊：
影响因子：
9.9
通讯作者：
Tonn, Joerg C.
中科院分区：
文献类型：
--
作者：
Suchorska, Bogdana;Jansen, Nathalie L.;Tonn, Joerg C.
目的：这项前瞻性纵向研究的目的是确定胶质母细胞瘤 (GBM) 患者的静态和动态 O-(2-[F-18]氟乙基)-l-酪氨酸 PET ((FET)-F-18-PET) 衍生的成像生物标志物。方法：纳入 79 名新诊断 GBM 患者； 42 名患者接受了立体定向活检（不可切除的肿瘤），37 名患者接受了显微手术肿瘤切除。所有患者均计划接受放疗加伴随和辅助替莫唑胺 (RCx/TMZ)。使用静态和动态分析的 (FET)-F-18-PET 评估在活检/切除前、切除后、RCx 后 4 至 6 周以及 TMZ 3 个周期后进行。终点是生存期和无进展生存期。从比例风险模型中获得预后因素。 结果：RCx 前的生物肿瘤体积 (BTVpreRCx) 是最重要的 (FET)-F-18-PET 衍生的成像生物标志物，并且独立于 MGMT 启动子甲基化和临床预后因素：BTVpreRCx 较小的患者具有显着更长的无进展生存期和总生存期 (OS)。治疗前的 (FET)-F-18 时间-活动曲线 (TAC) 及其在 RCx 后的变化也与结果相关； TAC 最初增加的患者经历了更长的 OS。结论：BTVpreRCx 和 TAC 代表 GBM 中重要的 (FET)-F-18-PET 衍生的成像生物标志物。 TAC 增加与 OS 延长相关。 BTVpreRCx 是无进展生存期和 OS 的一个强有力的预后因素，与手术方式无关。我们的数据进一步表明，携带可切除 GBM 的患者可能受益于最大程度的 PET 引导肿瘤切除术。
Objective:The aim of this prospective longitudinal study was to identify static and dynamic O-(2-[F-18]fluoroethyl)-l-tyrosine PET ((FET)-F-18-PET)-derived imaging biomarkers in patients with glioblastoma (GBM).Methods:Seventy-nine patients with newly diagnosed GBM were included; 42 patients underwent stereotactic biopsy (unresectable tumors) and 37 patients microsurgical tumor resection. All patients were scheduled to receive radiotherapy plus concomitant and adjuvant temozolomide (RCx/TMZ). (FET)-F-18-PET evaluation using static and dynamic analysis was done before biopsy/resection, after resection, 4 to 6 weeks following RCx, and after 3 cycles of TMZ. Endpoints were survival and progression-free-survival. Prognostic factors were obtained from proportional hazards models.Results:Biological tumor volume before RCx (BTVpreRCx) was the most important (FET)-F-18-PET-derived imaging biomarker and was independent of MGMT promoter methylation and clinical prognostic factors: patients with smaller BTVpreRCx had significantly longer progression-free and overall survival (OS). (FET)-F-18 time-activity curves (TACs) before treatment and their changes after RCx were also related to outcome; patients with initially increasing TACs experienced longer OS.Conclusion:BTVpreRCx and TAC represent important (FET)-F-18-PET-derived imaging biomarkers in GBM. Increasing TACs are associated with prolonged OS. The BTVpreRCx is a strong prognostic factor for progression-free survival and OS independent of the mode of surgery. Our data furthermore suggest that patients harboring resectable GBM might benefit from maximal PET-guided tumor resection.