Positron emission tomography in limited-stage small-cell lung cancer: A prospective study
Positron emission tomography in limited-stage small-cell lung cancer: A prospective study
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DOI：
10.1200/jco.2004.11.089
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发表时间：
2004-08-15
影响因子：
45.3
通讯作者：
Siegel, BA
中科院分区：
文献类型：
--
作者：
Bradley, JD;Dehdashti, F;Siegel, BA
[F-18][F-18]氟-2-脱氧-D-葡萄糖正电子发射断层扫描(FDG-PET)在常规分期基础上发现广泛期小细胞肺癌(SCLC)的频率，并确定PET对假定的有限期小细胞肺癌(SCLC)治疗计划的影响。对PET图像进行了评估，以寻找广泛期疾病的证据。每个患者的肿瘤-淋巴结-转移系统分期也被分配，有无PET信息。结果FDG-PET显示24例患者中有3例与广泛分期的小细胞肺癌相一致。FDG-PET正确地将24名患者中的2名(8.3%)诊断为广泛期疾病(95%CI，1.03%至27.0%)。PET能正确识别计算机断层扫描(CT)上怀疑的每个小细胞肺癌肿块(原发或结节)中的肿瘤，因此相对于CT，基于病变的敏感性为100%。在24例患者中，有6例(25%)发现了不可疑的区域淋巴结转移，放射治疗计划被显著改变，将PET阳性/CT阴性的淋巴结包括在这些患者的高剂量区域内。结论FDG-PET对小细胞肺癌的诊断具有较高的敏感性，对临床分期和治疗计划有一定的参考价值。(C)2004年，由美国临床肿瘤学会提供。
PurposeTo determine how often positron emission tomography with [F-18]fluoro-2-deoxy-D-glucose (FDG-PET) detects extensive-stage small-cell lung cancer (SCLC) in patients considered to have limited-stage disease based on conventional staging procedures, and to determine the impact of PET on treatment planning for presumed limited-stage SCLC.Patients and MethodsWe prospectively performed pretreatment FDG-PET on 24 patients determined by conventional staging methods to have limited-stage SCLC (defined as disease that could be encompassed within a reasonable radiotherapy portal, excluding bilateral supraclavicular disease). PET images were evaluated for evidence of extensive-stage disease. Tumor-node-metastasis system staging was also assigned for each patient, with and without PET information.ResultsFDG-PET demonstrated findings consistent with extensive-stage SCLC in three of 24 patients. FDG-PET correctly upstaged two (8.3%) of 24 patients to extensive-stage disease (95% CI, 1.03% to 27.0%). PET correctly identified tumor in each SCLC mass (primary or nodal) that was suspected on computed tomography (CT) imaging, thus giving a lesion-based sensitivity relative to CT of 100%. PET identified unsuspected regional nodal metastasis in six (25%) of 24 patients, and the radiation therapy plan was significantly altered to include the PET-positive/CT-negative nodes within the high-dose region in each of these patients. Brain PET images in 23 patients disclosed no evidence of brain metastasis.ConclusionFDG-PET has high sensitivity for SCLC and appears to be of value for initial staging and treatment planning of patients with presumed limited-stage disease. (C) 2004 by American Society of Clinical Oncology.