Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lung cancer and other types of cancer.
Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lung cancer and other types of cancer.
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FDG-PET发现对患者管理策略的决策的影响：肺癌患者和其他类型癌症的多中心试验。
DOI：
10.1007/s12149-015-0963-9
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发表时间：
2015-06
影响因子：
2.6
通讯作者：
Yamamoto, Hiroshi
中科院分区：
文献类型：
--
作者：
Kubota, Kazuo;Matsuno, Shinsuke;Morioka, Nobuo;Adachi, Shuji;Koizumi, Mitsuru;Seto, Hikaru;Kojo, Motohisa;Nishioka, Satoshi;Nishimura, Michihiko;Yamamoto, Hiroshi
迄今为止，已经对使用[18 F]-氟脱氧葡萄糖（FDG-PET）的正电子发射断层扫描的诊断能力进行了许多研究。然而，迄今为止，尚未报告旨在评价FDG-PET对日本医疗系统内患者管理策略选择的影响的研究。本研究的目的是前瞻性调查基于FDG-PET结果修改管理策略的患者比例（策略修改率）。通过比较患有9种癌症（肺癌、乳腺癌、结直肠癌、头颈癌、脑肿瘤、胰腺癌、恶性淋巴瘤、不明原因癌症和黑色素瘤）的560名癌症患者在FDG-PET后的患者管理策略（检查和治疗计划）与FDG-PET前的策略，计算策略修改率。此外，对患者管理策略的修改细节进行了分析。肺癌患者的策略修改率为71.6%（208例患者中的149例，95%置信区间为65.0- 77.7%），高于之前报道的FDG-PET前后肺癌策略修改率（25.6%）。非肺癌患者的策略调整率依次为乳腺癌44.4%（56/126）、结直肠癌75.6%（62/82）、头颈部癌65.2%（15/23）、恶性淋巴瘤70.0%（35/50）、胰腺癌85.0%（17/20）、乳腺癌10.0%（12/126）。不明原因癌占78.0%（32/41）。相对于FDG-PET之前的计划，FDG-PET之后的治疗计划的平均修改率（主要和次要修改）为55.4%（范围44.0- 69.2%），根据FDG-PET检查的目的，43.3- 68.2%的患者对治疗计划进行了重大修改。本研究的结果表明，FDG-PET可以有助于修改管理策略（特别是治疗计划），特别是对于肺癌患者，但也适用于其他类型癌症的患者。
To date, numerous studies have been conducted on the diagnostic capabilities of positron emission tomography using [18F]-fluorodeoxyglucose (FDG-PET). However, no studies designed to evaluate the influence of FDG-PET on the selection of patient management strategies within the Japanese healthcare system have been reported to date. The aim of the present study was to investigate prospectively the proportion of patients whose management strategies were modified based on FDG-PET findings (strategy modification rate). The strategy modification rate was calculated by comparing the patient management strategy (test and treatment plans) after FDG-PET with the strategy before FDG-PET for 560 cancer patients with nine types of cancer (lung cancer, breast cancer, colorectal cancer, head/neck cancer, brain tumor, pancreas cancer, malignant lymphoma, cancer of unknown origin, and melanoma). In addition, the details of the modifications to the patient management strategies were analyzed. The strategy modification rate for patients with lung cancer was 71.6 % (149 of 208 patients, 95 % confidence interval 65.0–77.7 %), which was higher than previously reported strategy modification rates for lung cancer before and after FDG-PET (25.6 %). The strategy modification rates for patients with cancers other than lung cancer were as follows: breast, 44.4 % (56/126); colorectal, 75.6 % (62/82); head and neck, 65.2 % (15/23); malignant lymphoma, 70.0 % (35/50); pancreas, 85.0 % (17/20); and cancer of unknown origin, 78.0 % (32/41). The mean modification rate (major and minor modifications) of the treatment plans after FDG-PET, relative to the plans before FDG-PET, was 55.4 % (range 44.0–69.2 %), with major modifications pertaining to the treatment plan made in 43.3–68.2 % of the patients based on the objectives of the FDG-PET examination. The results from this study indicate that FDG-PET can contribute to the modification of management strategies (particularly treatment plans), especially for lung cancer patients but also for patients with other types of cancer.
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影响因子：
3.6
作者：
FRYBACK, DG;THORNBURY, JR
通讯作者：
THORNBURY, JR
影响因子：
5.3
作者：
Verhagen, AFT;Bootsma, GP;Oyen, WJG
通讯作者：
Oyen, WJG
影响因子：
10
作者：
Herder, GJ;van Tinteren, H;Smit, EF
通讯作者：
Smit, EF
影响因子：
2.6
作者：
Lonneux, M;Lawson, G;Pauwels, S
通讯作者：
Pauwels, S
影响因子：
45.3
作者：
Bradley, JD;Dehdashti, F;Siegel, BA
通讯作者：
Siegel, BA