F-18 fluorodeoxyglucose uptake in primary cervical cancer as an indicator of prognosis after radiation therapy
F-18 fluorodeoxyglucose uptake in primary cervical cancer as an indicator of prognosis after radiation therapy
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DOI：
10.1016/j.ygyno.2005.10.005
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发表时间：
2006-04-01
影响因子：
4.7
通讯作者：
Grigsby, PW
中科院分区：
文献类型：
--
作者：
Xue, FY;Lin, LL;Grigsby, PW
目的.我们评估了在接受放疗联合或不同时化疗的宫颈癌患者中，使用葡萄糖类似物F-18氟脱氧葡萄糖（FDG-PET）进行的预处理正电子发射断层扫描中肿瘤代谢活性的预后意义。我们研究了96例连续的宫颈癌患者，这些患者在开始放疗前接受了FDG-PET，同时接受或不接受化疗。采用半定量标准化摄取值（SUV）评估原发肿瘤治疗前FDG摄取，并与无病生存期和总生存期相关。通过Kaplan-Meter方法估计存活率。单因素分析采用logistic似然比检验，多因素分析采用考克斯比例风险模型。最大SUV = 10.2的患者的5年无病生存率< 10.2 and >分别为71%和52%（P= 0.0289），而总生存率分别为72%和69%（P = 0.4）。多因素分析发现，FDG-PET显示的淋巴结转移是无病生存的预测因素（P < 0.0001）。FDG和FIGO第1期疾病的SUV均被发现对无病生存率有边缘预测作用（分别为P = 0.055和P = 0.058）。通过SUV测量的原发性宫颈癌内FDG摄取可预测接受宫颈癌放疗的患者的无病生存率。高FDG摄取可能有助于识别可能需要更积极的初始治疗的患者。(C)2005年爱思唯尔公司All rights reserved.
Purpose. We evaluated the prognostic significance of tumor metabolic activity on pretreatment positron emission tomography using the glucose analog F-18 fluorodeoxyglucose (FDG-PET) in patients with carcinoma of the cervix undergoing radiotherapy with or without concurrent chemotherapy.Methods. We studied 96 consecutive patients who underwent FDG-PET prior to initiation of radiotherapy with or without concurrent chemotherapy for carcinoma of the cervix. Pretreatment FDG uptake of the primary tumor was assessed with the semiquantitative standardized uptake value (SUV) and correlated with disease-free and overall survival. Survival was estimated by the Kaplan-Meter method. Univariate and multivariate analyses were performed with the logistic likelihood ratio test and the Cox proportional hazards model, respectively.Results. Five-year disease-free survivals in patients with maximal SUV < 10.2 and >= 10.2 were 71% and 52% (P= 0.0289) respectively, while overall survivals were 72% and 69% (P = 0.4), respectively. On multivariate analysis, lymph node metastasis on FDG-PET was found to be predictive of disease-free survival (P < 0.0001). Both the SUV for FDG and FIGO Stage 1 disease were found to be marginally predictive of disease-free survival (P = 0.055 and P = 0.058, respectively).Conclusions. FDG uptake within primary cervical cancer, as measured by SUV, is predictive of disease-free survival in patients undergoing radiotherapy for cervical cancer. High FDG uptake may be useful in identifying patients who may require more aggressive initial therapy. (C) 2005 Elsevier Inc. All rights reserved.