Evaluation of Response to Multikinase Inhibitor in Metastatic Renal Cell Carcinoma by FDG PET/Contrast-Enhanced CT
Evaluation of Response to Multikinase Inhibitor in Metastatic Renal Cell Carcinoma by FDG PET/Contrast-Enhanced CT
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DOI：
10.1097/rlu.0b013e3181f9ddd9
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发表时间：
2010-12-01
影响因子：
10.6
通讯作者：
Inoue, Tomio
中科院分区：
文献类型：
--
作者：
Minamimoto, Ryogo;Nakaigawa, Noboru;Inoue, Tomio
目的：多激酶抑制剂（MKI）是治疗转移性肾细胞癌（mRCC）的理想药物。我们解释了[（18）F]-2-氟-2-脱氧葡萄糖正电子发射断层扫描/对比增强计算机断层扫描（FDG PET/CECT）在评估MKI的早期反应和预测无进展生存期（PFS）方面对mRCC的有用性。在MKI治疗前和MKI治疗一个周期后进行FDG PET/CECT。根据欧洲癌症研究和治疗组织的PET评估对MKI的反应，根据实体瘤反应评估标准和中枢低衰减（CHA）的出现通过CT评估对MKI的反应。PET和CT之间的缓解评价在8例患者中相等（部分缓解[PR]：1例，疾病稳定[SD]：6例，疾病进展[PD]：1例）。在另外4例患者中，PET显示2例PR和2例PD，而CT显示所有4例患者均为SD。根据PET反应的PFS显示PR与SD之间（P <0.05）和PR与PD之间（P <0.05）的统计学显著差异，但PR与SD之间无统计学显著差异（P = 0.083）。MKI治疗后，8例患者的转移性病变中确认了CHA阳性。结论：FDGPET/CECT可用于评价MKI治疗mRCC的早期疗效和预测PFS。
Purpose: Multikinase inhibitor (MKI) is a promising drug for treatment of metastatic renal cell carcinoma (mRCC). We explained the usefulness of [(18)F]-2-fluoro-2-deoxyglucose positron emission tomography/contrast-enhanced computed tomography (FDG PET/CECT) for mRCC in evaluating the early response to MKI and in predicting progression-free survival (PFS).Methods: Patients who planned MKI treatment for mRCC were included in this prospective study. FDG PET/CECT was performed before MKI treatment and after one cycle of MKI treatment. Evaluation of the response to MKI was assessed by PET according to the European Organization for Research and Treatment of Cancer, by CT according to the Response Evaluation Criteria in Solid Tumors and appearance of central hypoattenuation (CHA).Results: Twelve patients were enrolled in the study. Equality of response evaluation between PET and CT was in 8 patients (partial response [PR] : 1, stable disease [SD] : 6, progressive disease [PD] : 1). Among the other 4 patients, PET showed 2 patients with PR and 2 patients with PD, in contrast to the CT finding of SD in all 4 patients. PFS according to PET response showed a statistically significant difference between PR and SD (P < 0.05) and between PR and PD (P < 0.05), but not between PR and SD (P = 0.083). Positive CHA in metastatic lesions after MKI treatment was confirmed in 8 patients. PFS with positive CHA was 233.8 days, while that without CHA was 75.0 days (P < 0.05).Conclusion: FDG PET/CECT shows potential for evaluating early treatment response to MKI in mRCC and for predicting PFS.