Feasibility of semiquantitative 18F-fluorodeoxyglucose PET/computed tomography in patients with advanced lung cancer for interim treatment evaluation of combining immunotherapy and chemotherapy.
Feasibility of semiquantitative 18F-fluorodeoxyglucose PET/computed tomography in patients with advanced lung cancer for interim treatment evaluation of combining immunotherapy and chemotherapy.
复制标题
半定量18F - 氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在晚期肺癌患者免疫治疗联合化疗中期疗效评估中的可行性
DOI：
10.1097/mnm.0000000000001428
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发表时间：
2021-09-01
影响因子：
1.5
通讯作者：
Meng X
中科院分区：
文献类型：
--
作者：
Ke L;Wu L;Yu J;Meng X
补充数字内容可在文本中找到。本研究旨在探讨18f -氟脱氧葡萄糖PET/CT （18F-FDG PET/CT）在免疫联合化疗的晚期肺癌患者中的预后价值。本回顾性研究纳入了51例晚期肺癌患者，这些患者于2018年1月至2020年1月在我院接受了4个周期的免疫联合化疗前的18F-FDG PET/CT成像。计算以下PET/CT参数：标准化摄取值SUVmax、SUVmean、SUVpeak、SUVsd、代谢肿瘤体积（MTV）、病灶总糖酵解（TLG）、MTV25%、MTV42%、MTV50%、MTV75%、全肺糖酵解（GLG）、靶本比（TBR）、SUVpeakwb、MTVwb、TLGwb、SUVmeanwb、SUVmaxwb。logistic回归分析用于评估基线代谢参数与治疗反应之间的关系。构建Kaplan-Meier估计曲线和log-rank检验进行生存分析。根据RECIST， 9名患者（18%）表现出部分缓解，25名患者（49%）出现SD， 17名患者（33%）出现进展性疾病。临床获益（CB）组的SUVmax、SUVpeak、MTV的平均值±SD均低于无临床获益（no-CB）组（均P < 0.05）。无CB组中位PFS为3.7个月，CB组中位PFS为9.9个月（P < 0.001）。多因素logistic分析显示，SUVmax和组织学是影响疗效评价的独立因素。此外，SUVmax是非小细胞肺癌疗效的独立预测因子。SUVmax可用于预测晚期肺癌免疫联合化疗的中期治疗反应。此外，结合SUVmax和组织学可以以可接受的可靠性预测治疗反应。然而，由于缺乏有限的证据，仍然需要一个大型的前瞻性多中心试验来检验上述发现。
Supplemental Digital Content is available in the text. This study aimed to investigate the prognosis value of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) in advanced lung cancer patients with immunotherapy combined with chemotherapy. Fifty-one advanced lung cancer patients were included in this retrospective study, who underwent 18F-FDG PET/CT imaging before four cycles of immunotherapy combined with chemotherapy at our institution between January 2018 and January 2020. The following PET/CT parameters were calculated: standardized uptake value SUVmax, SUVmean, SUVpeak, SUVsd, metabolic tumor volume (MTV), total lesion glycolysis (TLG), MTV25%, MTV42%, MTV50%, MTV75%, global lung glycolysis (GLG), target-to-background ratio (TBR), SUVpeakwb, MTVwb, TLGwb, SUVmeanwb, SUVmaxwb. Logistics regression analyses were used for assessing the association between baseline metabolic parameters and response to treatment. Kaplan–Meier estimator curves and the log-rank test were constructed for survival analyses. According to RECIST, nine patients (18%) showed partial response, 25 (49%) had SD, and 17 (33%) had progressive disease. The mean ± SD of SUVmax, SUVpeak, MTV were lower in clinical benefit (CB) group than no-clinical benefit (no-CB) group (all P < 0.05). Median PFS was 3.7 months in no-CB group and 9.9 months in CB group (P < 0.001). Multivariate logistic analysis indicated that SUVmax and histology were independent factors significantly related to the evaluation of therapeutic efficiency. Furthermore, SUVmax is an independent predictor of efficacy in non-small cell lung cancer. SUVmax can be used to predict interim treatment response of immunotherapy combination with chemotherapy for advanced lung cancer. Moreover, the combination of SUVmax and histology may predict treatment response with acceptable reliability. However, a large prospective multicenter trial is still needed to examine the above finding for lacking limited evidence.