Prognostic value of gross tumor volume delineated by FDG-PET-CT based radiotherapy treatment planning in patients with locally advanced pancreatic cancer treated with chemoradiotherapy
Prognostic value of gross tumor volume delineated by FDG-PET-CT based radiotherapy treatment planning in patients with locally advanced pancreatic cancer treated with chemoradiotherapy
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DOI：
10.1186/1748-717x-7-37
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发表时间：
2012-03-19
影响因子：
3.6
通讯作者：
Selek, Ugur
中科院分区：
文献类型：
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作者：
Parlak, Cem;Topkan, Erkan;Selek, Ugur
工作背景：我们的目的是评估通过融合对比增强计算机断层扫描（CT）和18 F-氟-脱氧-D-葡萄糖正电子发射断层扫描-CT确定的大体肿瘤体积（GTV）是否（FDG-PET-CT）的放射治疗计划可以预测结果，即总生存期（OS），局部区域无进展生存期（LRPFS），和无进展生存期（PFS）的情况下，局部晚期胰腺癌（LAPC）的治疗与明确的同步放化疗。方法：共有30例有组织学证据的LAPC患者接受了50.4戈伊（1.8戈伊/28次）放疗，同时持续输注5-FU，随后接受4至6个疗程的吉西他滨维持治疗。在基于FDG-PET-CT的RTP上进行靶体积描绘。根据受试者工作特征（ROC）分析，将患者分为GTV小于（GTV（L））和大于（GTV（G））临界值两组，并比较OS、LRPFS和PFS。结果：FDG-PET-CT数据显示的中位GTV为100.0 cm（3）。从ROC曲线确定的截止GTV值为91.1 cm（3）。在中位随访11.2个月时，整个人群的中位OS、LRPFS和PFS分别为10.3、7.8和5.7个月。GTV（L）和GTV（G）队列的中位OS、LRPFS和PFS分别为16.3和9.5（p = 0.005），11.0与6.0（p = 0.013），9.0 vs. 4.8个月（p = 0.008）。在GTV（L）患者中观察到上级OS、LRPFS和PFS优于GTV（G）患者，表明FDG-PET-CT定义的GTV大小在预测接受明确C-CRT治疗的LAPC患者的结局方面具有潜力，这需要通过更大队列的进一步研究来验证。
Background: We aimed to assess whether gross tumor volume (GTV) determined by fusion of contrast-enhanced computerized tomography (CT) and 18F-fluoro-deoxy-D-glucose positron emission tomography-CT (FDG-PET-CT) based radiotherapy planning could predict outcomes, namely overall survival (OS), local-regional progression-free survival (LRPFS), and progression-free survival (PFS) in cases with locally advanced pancreas cancer (LAPC) treated with definitive concurrent chemoradiotherapy.Methods: A total of 30 patients with histological proof of LAPC underwent 50.4 Gy (1.8 Gy/28 fractions) of radiotherapy concurrent with continuously infused 5-FU followed by 4 to 6 courses of maintenance gemcitabine. Target volume delineations were performed on FDG-PET-CT-based RTP. Patients were stratified into 2 groups: GTV lesser (GTV(L)) versus greater (GTV(G)) than cut off value determined by receiver operating characteristic (ROC) analysis, and compared in terms of OS, LRPFS and PFS.Results: Median GTV delineated according to the FDG-PET-CT data was 100.0 cm(3). Cut off GTV value determined from ROC curves was 91.1 cm(3). At a median follow up of 11.2 months, median OS, LRPFS and PFS for the entire population were 10.3, 7.8 and 5.7 months, respectively. Median OS, LRPFS and PFS for GTV(L) and GTV(G) cohorts were 16.3 vs. 9.5 (p = 0.005), 11.0 vs. 6.0 (p = 0.013), and 9.0 vs. 4.8 months (p = 0.008), respectively.Conclusions: The superior OS, LRPFS and PFS observed in GTV(L) patients over GTV(G) ones suggests a potential for FDG-PET-CT-defined GTV size in predicting outcomes of LAPC patients treated with definitive C-CRT, which needs to be validated by further studies with larger cohorts.