Contribution of PET/CT to Prediction of Outcome in Children and Young Adults with Rhabdomyosarcoma
Contribution of PET/CT to Prediction of Outcome in Children and Young Adults with Rhabdomyosarcoma
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DOI：
10.2967/jnumed.110.082511
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发表时间：
2011-10-01
影响因子：
9.3
通讯作者：
Weckesser, Matthias
中科院分区：
文献类型：
--
作者：
Baum, Sven H.;Fruehwald, Michael;Weckesser, Matthias
本回顾性研究的目的是评价（18）F-FDG PET或PET/CT在预测儿童和年轻人横纹肌肉瘤患者预后中的作用。研究方法：确定了41例接受PET或PET/CT检查的组织学证实的横纹肌肉瘤患者（年龄范围，1-20岁;平均年龄+/- SD，9.9 +/- 5.8岁）。将肿瘤最大标准化摄取值（SUV（max））和视觉评定的代谢活性，以及代谢活性淋巴结和远处转移的存在与无事件生存期和总生存期进行比较。进行多变量考克斯回归分析，以比较根据代谢性肿瘤强度与既定预后因素的预后预测。结果如下：Kaplan-Meier分析显示，视觉上被评定为高代谢活性或肝脏SUVmax与SUV之比大于4.6的原发性肿瘤的总生存期显著较短。此外，代谢活跃的淋巴结和远处部位受累表明生存率显著降低。在多变量考克斯回归分析中，原发肿瘤的强度或SUV（max）对预后的影响未能达到显著性，尽管PET的表现优于在较大患者组中建立的一些预后因素（P = 0.081）。结论：（18）F-FDG PET/CT对儿童横纹肌肉瘤的早期分期有重要价值。（18）F-FDG PET/CT可能是结果的额外预测因素，并可用于改进风险适应性治疗。PET的表现优于某些已确定的风险因素。多变量检验中原发肿瘤代谢的临界显著性水平可能是样本量有限的影响。进一步的前瞻性评价是必要的。
The purpose of this retrospective study was to evaluate the role of (18)F-FDG PET or PET/CT in the prediction of patient outcome in children and young adults affected by rhabdomyosarcoma. Methods: Forty-one patients with histology-proven rhabdomyosarcoma who underwent PET or PET/CT were identified (age range, 1-20 y; mean age +/- SD, 9.9 +/- 5.8 y). Tumor maximum standardized uptake value (SUV(max)) and visually rated metabolic activity, as well as the presence of metabolically active lymph nodes and distant metastases, were compared with event-free and overall survival. Multivariate Cox regression analyses were performed to compare the prediction of outcome according to metabolic tumor intensity in relation to established prognostic factors. Results: Kaplan-Meier analyses revealed a significantly shorter overall survival in primary tumors visually rated as highly metabolically active or with a ratio of SUVmax to SUV of the liver above 4.6. In addition, metabolically active lymph node and distant site involvement was indicative of significantly lower survival rates. On multivariate Cox regression analysis, the impact of intensity or SUV(max) of the primary tumor on outcome failed to attain significance, although PET performed better than some of the prognostic factors established in larger patient groups (P = 0.081). Conclusion: (18)F-FDG PET/CT is a valuable tool for initial staging in children affected by rhabdomyosarcoma. (18)F-FDG PET/CT may be an additional predictor of outcome and may be used to refine risk-adapted therapy. PET performed better than some established risk factors. The borderline significance level of primary tumor metabolism in multivariate testing may be an effect of the limited sample size. Further prospective evaluations are warranted.