[11C]Methionine Positron Emission Tomography and Survival in Patients with Bone and Soft Tissue Sarcomas Treated by Carbon Ion Radiotherapy
[11C]Methionine Positron Emission Tomography and Survival in Patients with Bone and Soft Tissue Sarcomas Treated by Carbon Ion Radiotherapy
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DOI：
10.1158/1078-0432.ccr-0190-3
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发表时间：
2004-03
影响因子：
11.5
通讯作者：
Hong Zhang;K. Yoshikawa;Katsumi Tamura;T. Tomemori;Ken Sagou;M. Tian;S. Kandatsu;T. Kamada;H. Tsuji;T. Suhara;Kazutoshi Suzuki;S. Tanada;H. Tsujii
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作者：
Hong Zhang;K. Yoshikawa;Katsumi Tamura;T. Tomemori;Ken Sagou;M. Tian;S. Kandatsu;T. Kamada;H. Tsuji;T. Suhara;Kazutoshi Suzuki;S. Tanada;H. Tsujii
目的：新型碳离子放射治疗（CIRT）在治疗难治性癌症中的发展导致需要一种准确评估患者预后的方法。我们评估了CIRT后l-[甲基-11 C]-蛋氨酸（MET）摄取及其变化是否是不可切除骨和软组织肉瘤患者的早期生存预测因子。实验设计：对62例不能切除的骨和软组织肉瘤患者在CIRT前和CIRT后1个月内进行了MET正电子发射断层扫描。用半定量肿瘤：非肿瘤比率（T/N比率）测量肿瘤MET摄取。将肿瘤中MET摄取和相关临床参数输入单因素和多因素生存分析。结果：全组中位生存期为20个月。基线T/N比≤6的患者的生存率显著高于基线T/N比>6的患者（2年生存率：69.4% vs 32.3%; P = 0.01）。CIRT后比值≤4.4的患者的生存率高于CIRT后比值>4.4的患者（2年生存率：63.7% vs 41.3%; P = 0.01）。治疗后MET摄取变化>30%的患者的生存率显著高于变化较低的患者（2年生存率：74.6% vs 41.6%; P = 0.049）。多变量分析显示，基线和CIRT后T/N比值是患者生存率的统计学显著独立预测因素。T/N比值越大，预后越差。结论：通过基线或CIRT后T/N比测量的MET摄取是碳离子放疗治疗的骨和软组织肉瘤患者生存的独立预测因子，而治疗后MET摄取变化可能具有相同目的的潜在价值。
Purpose: The development of the novel carbon ion radiotherapy (CIRT) in the treatment of refractory cancers has resulted in the need for a way to accurately evaluate patient prognosis. We evaluated whether l-[methyl-11C]-methionine (MET) uptake and its change after CIRT were the early survival predictors in patients with unresectable bone and soft tissue sarcomas. Experimental Design: MET positron emission tomography was prospectively performed in 62 patients with unresectable bone and soft tissue sarcomas before and within 1 month after CIRT. Tumor MET uptake was measured with the semiquantitative tumor:nontumor ratio (T/N ratio). The MET uptake in the tumor and relevant clinical parameters were entered into univariate and multivariate survival analysis. Results: The overall median survival time was 20 months. Patients with a baseline T/N ratio of ≤6 had a significant better survival than patients with a baseline T/N ratio >6 (2-year survival rate: 69.4% versus 32.3%; P = 0.01). Patients with a post-CIRT ratio of ≤4.4 had a better survival than that with a post-CIRT ratio >4.4 (2-year survival rate: 63.7% versus 41.3%; P = 0.01). A significant higher survival rate was observed in patients with post-therapeutic MET uptake change of >30% than patients in lower change group (2-year survival rate: 74.6% versus 41.6%; P = 0.049). The multivariate analysis showed that both baseline and post-CIRT T/N ratio were statistically significant independent predictors of patient survival. Tumors with larger T/N ratio had a significantly poorer prognosis. Conclusions: MET uptake as measured by either baseline or post-CIRT T/N ratio was an independent predictor of survival in patients with bone and soft tissue sarcomas treated by carbon ion radiotherapy, whereas post-therapeutic MET uptake change might have potential value for the same purpose.