Total lesion glycolysis in positron emission tomography is a better predictor of outcome than the International Prognostic Index for patients with diffuse large B cell lymphoma
Total lesion glycolysis in positron emission tomography is a better predictor of outcome than the International Prognostic Index for patients with diffuse large B cell lymphoma
复制标题
DOI：
10.1002/cncr.27855
复制
发表时间：
2013-03-15
期刊：
影响因子：
6.2
通讯作者：
Heo, Dae Seog
中科院分区：
文献类型：
--
作者：
Kim, Tae Min;Paeng, Jin Chul;Heo, Dae Seog
背景：本研究旨在评估 [18F]2-氟-2-脱氧葡萄糖 (FDG)-正电子发射断层扫描 (PET) 定量代谢参数对弥漫性大 B 细胞淋巴瘤 (DLBCL) 的预后价值。方法：共有 140 名 DLBCL 患者在利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松龙 (R-CHOP) 化疗前接受了 FDG-PET 扫描。计算最大标准化摄取值（SUVmax）和总病灶糖酵解（TLG），边缘阈值为所有病灶SUVmax的25%、50%和75%。根据代谢参数和国际预后指数（IPI）比较各组之间的治疗结果。结果：中位随访 28.5 个月（范围 5-81 个月）后，2 年无进展生存率 (PFS) 和总生存率 (OS) 分别为 83% 和 87%。在代谢参数中，阈值 50% 的 TLG (TLG50) 与治疗结果显着相关。与低 TLG50 值 (415.5) 相比，高 TLG50 值 (>415.5) 与生存率降低相关（2 年 PFS 分别为 73% 与 92%，P = .007；2 年 OS 分别为 81% 与 93%，P = .031）。高 IPI 评分 (3) 显着降低 OS（2 年 OS 分别为 79% 和 90%，P = .049）。安娜堡 III/IV 期对 PFS 产生不利影响 (P = .013)。然而，高 IPI 评分和 III/V 安娜堡分期并未分别显着缩短 PFS (P = .200) 和 OS (P = .921)。高 TLG50 值通过多变量分析独立预测生存率（风险比 = 4.4；95% 置信区间 = 1.5-13.1；PFS 的 P = .008，风险比 = 3.1；95% 置信区间 = 1.0-9.6；OS P = .049）。结论：体积和代谢（即 TLG）的联合评估可以预测接受 R-CHOP 治疗的 DLBCL 患者的生存情况。癌症 2013。(c) 2012 美国癌症协会。
BACKGROUND: This study was undertaken to evaluate the prognostic value of quantitative metabolic parameters in [18F]2-fluoro-2-deoxyglucose (FDG)-positron emission tomography (PET) for diffuse large B cell lymphoma (DLBCL). METHODS: A total of 140 DLBCL patients underwent FDG-PET scans before rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy. The maximal standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were calculated, with the margin thresholds as 25%, 50%, and 75% of SUVmax of all lesions. Treatment outcomes were compared between groups according to metabolic parameters and the International Prognostic Index (IPI). RESULTS: After a median follow-up of 28.5 months (range, 5-81 months), the 2-year progression-free survival (PFS) and overall survival (OS) were 83% and 87%, respectively. Among metabolic parameters, TLG at the threshold of 50% (TLG50) was significantly associated with treatment outcomes. High TLG50 values (>415.5) were associated with reduced survivals compared with low TLG50 values (415.5) (2-year PFS of 73% versus 92%, P = .007; and 2-year OS of 81% versus 93%, P = .031). High IPI score (3) significantly reduced OS (2-year OS of 79% versus 90%, P = .049). Ann Arbor stage III/IV adversely affected PFS (P = .013). However, high IPI score and Ann Arbor stage of III/V did not significantly shorten PFS (P = .200) and OS (P = .921), respectively. High TLG50 values independently predicted survivals by multivariate analysis (hazard ratio = 4.4; 95% confidence interval = 1.5-13.1; P = .008 for PFS and hazard ratio = 3.1; 95% confidence interval = 1.0-9.6; P = .049 for OS). CONCLUSIONS: Combined assessment of volume and metabolism (ie, TLG) is predictive of survivals in DLBCL patients who are treated with R-CHOP. Cancer 2013. (c) 2012 American Cancer Society.