2-[18F]-Fluoro-2-deoxy-D-glucose positron emission tomography as guidance for primary treatment in patients with advanced-stage resectable squamous cell carcinoma of the larynx and hypopharynx
2-[18F]-Fluoro-2-deoxy-D-glucose positron emission tomography as guidance for primary treatment in patients with advanced-stage resectable squamous cell carcinoma of the larynx and hypopharynx
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DOI：
10.1016/j.ejso.2007.01.002
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发表时间：
2007-08-01
期刊：
影响因子：
3.8
通讯作者：
Kim, S. Y.
中科院分区：
文献类型：
--
作者：
Roh, J.-L.;Pae, K. H.;Kim, S. Y.
背景：2-[F-18]-氟-2-脱氧-d -葡萄糖（FDG）的高摄取与不良结果相关。预处理FDG摄取被评估为喉部和下咽鳞状细胞癌（SCC）患者生存和指导初级手术或放疗（RT）的预测因子。材料与方法：连续79例新诊断晚期可切除喉部及下咽鳞状细胞癌患者，术前行FDG正电子发射断层扫描(PET) +放疗+化疗（手术组40例）或放疗+化疗+手术挽救（RT组39例）。分析年龄、肿瘤分期、组织学分级、治疗策略和标准化摄取值（SUV）与局部控制和生存的关系。结果：两组整体局部控制率和生存率无显著差异（P < 0.01）。在单因素分析中，淋巴结阳性（P = 0.014）和SUV > 8.0 （P = 0.007）与较差的无病生存（DFS）相关。在多变量分析中，SUV仍然是DFS的独立决定因素（P = 0.014）。两治疗组分别分析SUV > 8.0患者时，手术组患者的3年DFS倾向于高于RT组，但无统计学意义（48%比27%，P=0.085）。结论：高FDG摄取与晚期喉部鳞状细胞癌患者的低生存率相关。FDG摄取高的患者可以通过手术切除、放疗和化疗来更好地治疗。(c) 2007 Elsevier Ltd.版权所有。
Background: High uptake of 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) is associated with unfavorable results. Pretreatment FDG uptake was evaluated as a predictor of survival and guidance for primary surgery or radiotherapy (RT) in patients with squamous cell carcinoma (SCC) of the larynx and hypopharynx.Materials and methods: Seventy-nine consecutive patients with newly diagnosed advanced resectable SCC of the larynx and hypopharynx underwent FDG positron emission tomography (PET) before surgical resection plus RT and chemotherapy (surgery group, n = 40) or RT with chemotherapy and surgical salvage (RT group, n = 39). Age, tumor stage, histological grade, treatment strategy, and standardized uptake value (SUV) were analyzed for association with local control and survival.Results: Overall local control and survival in the two groups did not differ (P > 0.1). In univariate analysis, nodal positivity (P = 0.014) and SUV > 8.0 (P = 0.007) were associated with poorer disease-free survival (DFS). In multivariate analysis, SUV remained an independent determinant of DFS (P = 0.014). When patients with SUV > 8.0 in the two treatment groups were analyzed separately, those in the surgery group tended to have a higher 3-year DFS than those in the RT group, despite no statistical significance (48% vs. 27%, P=0.085).Conclusions: High FDG uptake is associated with poor survival in patients with advanced laryngopharyngeal SCC. Patients with high FDG uptake may be better treated by surgical resection followed by RT and chemotherapy. (c) 2007 Elsevier Ltd. All rights reserved.