Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography
Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography
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DOI：
10.1200/jco.2006.05.7406
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发表时间：
2006-12-01
影响因子：
45.3
通讯作者：
Campone, Mario
中科院分区：
文献类型：
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作者：
Rousseau, Caroline;Devillers, Anne;Campone, Mario
目的本研究旨在前瞻性地评估序贯[F-18]氟脱氧葡萄糖正电子发射断层扫描（FDGPET）评估II期和III期乳腺癌患者新辅助化疗早期反应的有效性。患者和方法64例患者在给予FDG后用PET/计算机断层扫描仪获得图像（5 MBq/kg）在基线和化疗的第一，第二，第三和第六个疗程后。超声和乳房X光检查用于评估肿瘤大小。标准化摄取值（SUV）与PET的减少与病理responsibility.ResultsSurgery进行了6个疗程的化疗和病理分析后，发现在28例患者和36例患者的微小残留病变的大体残留病变。尽管SUV数据在无应答者中变化不大（基于病理学结果），但在94%（36例中的34例）的应答者中显著降低至背景水平。以基线SUV的60%为界值，化疗1个疗程后，FDGPET的敏感性、特异性和阴性预测值分别为61%、96%和68%，化疗2个疗程后分别为89%、95%和85%，化疗3个疗程后分别为88%、73%和83%。超声（US）和乳腺X线摄影的相同参数分别为64%、43%和55%，以及31%、56%和45%。评估肿瘤反应与美国或乳房X线摄影是从来没有显着的cutoff. ConclusionPathological反应，新辅助化疗在第II和III期乳腺癌化疗两个疗程后，FDG PET可以准确地预测。
PurposeThis study aimed to assess prospectively the efficacy of sequential [F-18]fluorodeoxyglucose positron emission tomography (FDG PET) to evaluate early response to neoadjuvant chemotherapy in stage II and III breast cancer patients.Patients and MethodsImages were acquired with a PET/computed tomography scanner in 64 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third, and sixth course of chemotherapy. Ultrasound and mammography were used to assess tumor size. Decrease in the standardized uptake value (SUV) with PET was compared with the pathologic response.ResultsSurgery was performed after six courses of chemotherapy and pathologic analysis revealed gross residual disease in 28 patients and minimal residual disease in 36 patients. Although SUV data did not vary much in nonresponders (based on pathology findings), they decreased markedly to background levels in 94% (34 of 36) of responders. When using 60% of SUV at baseline as the cutoff value, the sensitivity, specificity, and negative predictive value of FDG PET were 61%, 96%, and 68% after one course of chemotherapy, 89%, 95%, and 85% after two courses, and 88%, 73% and 83% after three courses respectively. The same parameters with ultrasound (US) and,, mammography were 64%, 43%, and 55%, and 31%, 56%, and 45%, respectively. Assessment of tumor response with US or mammography was never significant whatever the cutoff.ConclusionPathologic response to neoadjuvant chemotherapy in stage II and III breast cancer can be predicted accurately by FDG PET after two courses of chemotherapy.