Chemotherapy response evaluation with FDG-PET in patients with colorectal cancer
Chemotherapy response evaluation with FDG-PET in patients with colorectal cancer
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DOI：
10.1093/annonc/mdm470
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发表时间：
2008-02-01
影响因子：
50.5
通讯作者：
Oyen, W. J. G.
中科院分区：
文献类型：
--
作者：
de Geus-Oei, L. F.;van Laarhoven, H. W. M.;Oyen, W. J. G.
背景：本前瞻性研究的目的是评估f -18-氟脱氧葡萄糖-正电子发射断层扫描（FDG-PET）在早期评估晚期结直肠癌患者化疗反应中的价值。方法：分别于治疗前（n = 50）和治疗后6个月（n = 19）进行动态FDG-PET检测。对定量Patlak分析[葡萄糖代谢率（MRGlu）]和葡萄糖代谢测量的简化方法[标准化摄取值（SUV）]进行了评价。采用Cox比例回归分析评估糖代谢变化的预测价值。总生存期（OS）和无进展生存期（PFS）采用Kaplan-Meier估计计算。结果:有增加死亡率(P = 0.049为三角洲MRGlu PET1-2;为δSUV PET1-2 P = 0.017; P = 0.032为三角洲MRGlu PET1-3;三角洲SUV PET1-3 P = 0.048)和进展(P = 0.026为三角洲MRGlu PET1-2;为δSUV PET1-2 P = 0.035; P = 0.041为三角洲MRGlu PET1-3;三角洲SUV PET1-3 P = 0.081)的响应较差Cox比例回归分析评估的宠物。OS和PFS分析显示在Delta MRGlu和Delta SUV截止水平的大范围内具有显著的预测价值。结论：化疗诱导的肿瘤糖代谢改变程度可高度预测患者预后。由于简化的方法（SUV）足够可靠，使用FDG-PET进行治疗监测在临床上似乎是可行的。
Background: The aim of this prospective study was to evaluate the value of F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) for early assessment of chemotherapy response in patients with advanced colorectal cancer.Methods: Dynamic FDG-PET was carried out before and at 2 (n = 50) and 6 months (n = 19) after the start of treatment. Quantitative Patlak analysis [metabolic rate of glucose (MRGlu)] and a simplified method to measure glucose metabolism [standardized uptake value (SUV)] were evaluated. The predictive value of changes in glucose metabolism was assessed with Cox proportional regression analysis. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan-Meier estimates.Results: There was an increase in the rates of death (P = 0.049 for Delta MRGlu PET1-2; P = 0.017 for Delta SUV PET1-2; P = 0.032 for Delta MRGlu PET1-3; P = 0.048 for Delta SUV PET1-3) and progression (P = 0.026 for Delta MRGlu PET1-2; P = 0.035 for Delta SUV PET1-2; P = 0.041 for Delta MRGlu PET1-3; P = 0.081 for Delta SUV PET1-3) associated with worse response as assessed by PET on Cox proportional regression analysis. The OS and PFS analysis showed a significant predictive value at broad ranges of Delta MRGlu and Delta SUV cut-off levels.Conclusion: The degree of chemotherapy-induced changes in tumor glucose metabolism is highly predictive for patient outcome. The use of FDG-PET for therapy monitoring seems clinically feasible since simplified methods (SUV) are sufficiently reliable.