The Predictive Value of Early Changes in 18F-Fluoroestradiol Positron Emission Tomography/Computed Tomography During Fulvestrant 500 mg Therapy in Patients with Estrogen Receptor-Positive Metastatic Breast Cancer
The Predictive Value of Early Changes in 18F-Fluoroestradiol Positron Emission Tomography/Computed Tomography During Fulvestrant 500 mg Therapy in Patients with Estrogen Receptor-Positive Metastatic Breast Cancer
复制标题
雌激素受体阳性转移性乳腺癌患者氟维司群 500 mg 治疗期间 (18) F-氟雌二醇正电子发射断层扫描/计算机断层扫描早期变化的预测价值。
DOI：
10.1634/theoncologist.2019-0561
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发表时间：
2020-04-28
期刊：
影响因子：
5.8
通讯作者：
Shao, Zhiming
中科院分区：
文献类型：
--
作者：
He, Min;Liu, Cheng;Shao, Zhiming
背景：本研究的目的是探讨在雌激素受体(ER)阳性的转移性乳腺癌患者接受氟维司他500 mg治疗期间，F-18-FES正电子发射断层扫描(PET)/计算机断层扫描(CT)早期变化的预测价值。材料与方法患者分别在基线(扫描1)和第28天(扫描2)进行F-18-FES PET/CT扫描。每次扫描确定所有转移灶的最大标准摄取值(SUVmax)，计算SUVmax减少的百分比[(扫描1的SUVmax-扫描2的SUVmax)/扫描1的SUVmax]*100%。结果36例患者共发现294个F-18-FES阳性病灶。F-18-FES SUVmax在病变(中位数5.7；范围1.8-32.4)和患者(中位数5.1；范围2.5-13.2)之间差异很大。治疗后，皮损和患者的SUVmax中位数分别为2.1和2.1。Delta SUVmax范围为-5.1%~100%，中位数减少61.3%。通过受试者工作特性分析，确定区分临床受益患者的最佳分界点为38.0%。Delta SUVmax和Gt；中位数为38.0%的患者无进展生存期(PFS)显著长于Delta SUVmax=38.0%的患者，是接受FUVSTRANT治疗的患者PFS受益的独立预测因素。结论F-18-FES PET/CT系列成像测量的SUVmax变化可以早期用于预测接受FUVSTRANT治疗的患者PFS受益。
Background The aim of this study was to investigate the predictive value of early changes in F-18-fluoroestradiol (FES) positron emission tomography (PET)/computed tomography (CT) during fulvestrant 500 mg therapy in patients with estrogen receptor (ER)-positive metastatic breast cancer.Materials and Methods Patients underwent F-18-FES PET/CT scans at both baseline (scan 1) and day 28 (scan 2). The maximum standardized uptake value (SUVmax) of all metastatic sites was determined in each scan, and the percentage reduction in SUVmax (Delta SUVmax) was calculated as [(SUVmax on scan 1-SUVmax on scan 2)/ SUVmax on scan 1] * 100%.Results In total, 294 F-18-FES-positive lesions from 36 patients were identified. The F-18-FES SUVmax varied widely among lesions (median 5.7; range 1.8-32.4) and patients (median 5.1; range 2.5-13.2). After treatment, the median SUVmax among lesions and patients was 2.1 and 2.1, respectively. The Delta SUVmax ranged from -5.1% to 100%, with a median reduction of 61.3%. Using receiver operating characteristic analysis, the optimal cutoff point to discriminate patients who could derive clinical benefit from fulvestrant was determined to be 38.0%. Patients with a median Delta SUVmax >= 38.0% experienced significantly longer progression-free survival (PFS) than those with Delta SUVmax = 38.0% was an independent predictor of PFS benefit in patients receiving fulvestrant therapy.Conclusion Changes in SUVmax measured by serial imaging of F-18-FES PET/CT could be used early to predict PFS benefit in patients receiving fulvestrant therapy.