Is standardised 18F-FDG uptake value an outcome predictor in patients with stage III non-small cell lung cancer?
Is standardised 18F-FDG uptake value an outcome predictor in patients with stage III non-small cell lung cancer?
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DOI：
10.1007/s00259-005-1953-2
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发表时间：
2006-03-01
影响因子：
9.1
通讯作者：
Bares, R
中科院分区：
文献类型：
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作者：
Eschmann, SM;Friedel, G;Bares, R
目的：最近的研究表明，F-18-FDG摄取作为可手术非小细胞肺癌（NSCLC）复发的独立预后因素。这与FDG摄取与肿瘤细胞的增殖活性相关的实验发现相一致（Higashi等人，J Nucl Med 2000;41：85-92）。在此基础上，我们研究了FDG摄取对晚期NSCLC患者预后和远处转移发生的影响。方法：159例UICC Ⅲ A或Ⅲ B期NSCLC患者纳入本研究。在所有患者中，计划进行新辅助治疗以实现手术。在开始治疗前进行FDG PET作为额外的分期程序。可以获得137例患者的总生存期、无病生存期和远处转移发生率方面的临床结局数据，并与肿瘤的平均标准化摄取值（SUVavg）相关。此外，其他因素影响SUVavg和患者的结果（组织学肿瘤类型，分级，UICC阶段，肿瘤大小）进行了analysed.Results：SUVavg是显着影响肿瘤组织学，UICC阶段和肿瘤大小。分级无显著差异。在159名患者中的38名（24%）中，FDG PET显示了先前未怀疑的远处转移。远处转移的发生率与SUVavg显著相关。总体生存率往往会随着SUVavg的增加而降低;然而，只有当截止值为12.0时才达到显著性（p=0.05）。结论：FDG摄取是UICC III期NSCLC患者的独立预后因素，尽管与I/II期肿瘤相比，FDG摄取的差异性较小。
Purpose: Recent studies have demonstrated the relevance of F-18-FDG uptake as an independent prognostic factor for recurrence of operable non-small cell lung cancer (NSCLC). This corresponds with the experimental finding that FDG uptake correlates with the proliferative activity of tumour cells (Higashi et al., J Nucl Med 2000;41:85-92). On the basis of these observations, we studied the influence of FDG uptake on prognosis and occurrence of distant metastases in patients with advanced NSCLC.Methods: One hundred and fifty-nine patients with NSCLC of UICC stage IIIA or IIIB were included in the study. In all patients, neoadjuvant treatment was planned to achieve operability. FDG PET was performed as an additional staging procedure prior to the initiation of therapy. Clinical outcome data in terms of overall survival, disease-free survival and incidence of distant metastases could be obtained for 137 patients and were correlated with the average standardised uptake value of the tumour (SUVavg). Furthermore, other factors influencing SUVavg and patient outcome (histological tumour type, grading, UICC stage, tumour size) were analysed.Results: SUVavg was significantly influenced by tumour histology, UICC stage and tumour size. No significant difference could be shown for grading. In 38 out of the 159 patients (24%), FDG PET revealed previously unsuspected distant metastases. The incidence of distant metastases significantly correlated with SUVavg. Overall survival tended to decrease with increasing SUVavg; however, significance was only reached when a cut-off of 12.0 was applied (p=0.05).Conclusion: FDG uptake is an independent prognostic factor in patients with UICC stage III NSCLC, although less distinctively so than has been reported for stage I/II tumours.