Metabolic tumor burden predicts for disease progression and death in lung cancer
Metabolic tumor burden predicts for disease progression and death in lung cancer
复制标题
DOI：
10.1016/j.ijrobp.2007.04.036
复制
发表时间：
2007-10-01
影响因子：
7
通讯作者：
Loo, Billy W.
中科院分区：
文献类型：
--
作者：
Lee, Percy;Weerasuriya, Dilam K.;Loo, Billy W.
目的：在肺癌中，分期是疾病进展和生存的重要预后因素。然而，分期可能只是潜在肿瘤负荷的替代。我们的目的是评估F-18-氟脱氧葡萄糖-正电子发射断层扫描（FDG-PET）imaging.Patients和Methods测量的肿瘤负荷的预后价值：我们确定了19例肺癌患者，他们在任何治疗前进行了分期PET-CT扫描，并进行了充分的随访（18例完成进展时间，19例中有15例死亡）。使用定制软件在治疗前PET扫描上半自动分割代谢活性肿瘤区域。我们确定了疾病进展时间（TTP）和死亡时间（OS）与两个PET参数：总代谢肿瘤体积（MTV）和标准化摄取值（SUV.Results）之间的关系：估计的中位TTP和OS为9.3个月和14.8个月。在多变量考克斯比例风险回归分析中，MTV增加25 ml（第75次和第25次之间的差异）与进展和死亡风险增加相关（5.4倍和7.6倍），具有统计学显著性（p = 0.0014和p = 0.001）在控制了分期、治疗意图（明确或姑息）、年龄、Karnofsky体能状态和体重减轻后。我们没有发现SUV和TTP或OS.Conclusions之间的显着关系：在这项研究中，高肿瘤负荷评估PET MTV是一个独立的肺癌预后不良的功能，有希望分层患者的随机试验，并最终选择风险适应疗法。这些结果需要在更大的队列中进行验证，随访时间更长，并进行前瞻性评价。(c)2007年爱思唯尔公司
Purpose: In lung cancer, stage is an important prognostic factor for disease progression and survival. However, stage may be simply a surrogate for underlying tumor burden. Our purpose was to assess the prognostic value of tumor burden measured by F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging.Patients and Methods: We identified 19 patients with lung cancer who had staging PET-CT scans before any therapy, and adequate follow-up (complete to time of progression for 18, and death for 15 of 19). Metabolically active tumor regions were segmented on pretreatment PET scans semi-automatically using custom software. We determined the relationship between times to progression (TTP) and death (OS) and two PET parameters: total metabolic tumor volume (MTV), and standardized uptake value (SUV).Results: The estimated median TTP and OS for the cohort were 9.3 months and 14.8 months. On multivariate Cox proportional hazards regression analysis, an increase in MTV of 25 ml (difference between the 75th and 25th percentiles) was associated with increased hazard of progression and of death (5.4-fold and 7.6-fold), statistically significant (p = 0.0014 and p = 0.001) after controlling for stage, treatment intent (definitive or palliative), age, Karnofsky performance status, and weight loss. We did not find a significant relationship between SUV and TTP or OS.Conclusions: In this study, high tumor burden assessed by PET MTV is an independent poor prognostic feature in lung cancer, promising for stratifying patients in randomized trials and ultimately for selecting risk-adapted therapies. These results will need to be validated in larger cohorts with longer follow-up, and evaluated prospectively. (c) 2007 Elsevier Inc.