FDG PET/CT as a prognostic biomarker in the era of molecular-targeting therapies: max SUVmax predicts survival of patients with advanced renal cell carcinoma.
FDG PET/CT as a prognostic biomarker in the era of molecular-targeting therapies: max SUVmax predicts survival of patients with advanced renal cell carcinoma.
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DOI：
10.1186/s12885-016-2097-4
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发表时间：
2016-02-08
期刊：
影响因子：
3.8
通讯作者：
Yao M
中科院分区：
文献类型：
--
作者：
Nakaigawa N;Kondo K;Tateishi U;Minamimoto R;Kaneta T;Namura K;Ueno D;Kobayashi K;Kishida T;Ikeda I;Hasumi H;Makiyama K;Kubota Y;Inoue T;Yao M
各种分子靶向治疗已成为可用于治疗晚期肾细胞癌（RCC）。准确的诊断对于为个别病人选择适当的治疗是必要的。18F-2-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）是一种无创性的评估葡萄糖蓄积的工具，可作为癌症生物学特征的指标。我们前瞻性评估FDG PET/CT作为晚期RCC患者预后指标。在2008年至2014年期间，共招募了101例计划接受不同系统治疗的晚期RCC患者。共有61例患者复发RCC（58例转移性和3例区域性）和40例IV期RCC（36例转移性和4例局部性）。16例未行肾切除术。进行治疗前FDG PET/CT，并记录最大SUVmax（每例患者的最高SUV测量值）。将最大SUVmax与不同的临床危险因素作为预后指标进行比较。中位观察期为18个月（范围1-70个月）。101例受试者的最大SUVmax范围为无法检测到23.0（中位数6.9）。最大SUVmax高的患者预后差。标准危险因素的多变量分析显示，最大SUV最大值是生存率的独立预测因子（p < 0.001;风险比1.265; 95%置信区间1.159-1.380）。在我们之前的报告中，最大SUVmax的截止值为8.8，具有高度显著性（p < 0.0001）。当我们对最大SUVmax值进行细分时，最大SUVmax < 7.0的受试者的中位总生存期为41.9个月。最大SUV最大值在7.0 ~ 12.0之间的受试者平均随访时间为20.6个月。最大SUVmax ≥ 12.0的受试者平均随访时间为4.2个月。差异有统计学意义。FDG PET/CT评估的治疗前最大SUVmax是晚期RCC患者的一个有用的预后指标，为临床决策提供了有用的信息。
Various molecular-targeting therapies have become available for the treatment of advanced renal cell carcinoma (RCC). Accurate prognostication is desirable for choosing the appropriate treatment for individual patients. 18F-2-fluoro-2-deoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) is a non-invasive tool for evaluating glucose accumulation, which can be an index of biological characteristics of cancer. We prospectively evaluated FDG PET/CT as a prognostic indicator in patients with advanced RCC. A total of 101 patients slated for different systematic therapies for advanced RCC were enrolled between 2008 and 2014. A total of 61 patients had recurrent RCC (58 metastatic and 3 regional) and 40 patients had stage IV RCC (36 metastatic and 4 locoregional). Sixteen patients had not undergone nephrectomy. Pre-treatment FDG PET/CT was performed, and the max SUVmax (the highest SUV measurement in each patient) was recorded. The max SUVmax was compared with different clinical risk factors as prognostic indicators. The median observation period was 18 months (range 1–70 months). The max SUVmax of the 101 subjects ranged from undetectable to 23.0 (median 6.9). Patients with high max SUVmax had a poor prognosis. Multivariate analysis with standard risk factors revealed that max SUVmax was an independent predictor of survival (p < 0.001; hazard ratio 1.265; 95 % confidence interval 1.159–1.380). A cutoff of 8.8 for max SUVmax advocated in our previous report was highly significant (p < 0.0001). When we subclassified the max SUVmax values, the median overall survival of subjects with max SUVmax < 7.0 was 41.9 months. That of subjects with max SUVmax between 7.0 and 12.0 was 20.6 months. That of subjects with max SUVmax ≥ 12.0 was 4.2 months. The differences were statistically significant. Pretreatment max SUVmax assessed by FDG PET/CT is a useful prognostic marker for patients with advanced RCC, providing helpful information for clinical decision making.