Meningioma treated with interferon-alpha, evaluated with [(11)C]-L-methionine positron emission tomography.
Meningioma treated with interferon-alpha, evaluated with [(11)C]-L-methionine positron emission tomography.
复制标题
用干扰素-α治疗的脑膜瘤，通过[(11)C]-L-甲硫氨酸正电子发射断层扫描进行评估。
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
B. Långström
中科院分区：
文献类型：
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作者：
C. Muhr;O. Gudjonsson;A. Lilja;M. Hartman;Zhi;B. Långström
目的
在脑膜瘤患者术后残留肿块，复发或主要无法手术的肿瘤，正电子发射断层扫描（PET）与[（11）C]-L-蛋氨酸被用来评估IFN-α的治疗效果。
实验设计
12名患者用IFN-α治疗，剂量为150 - 500万IU s.c.日报在IFN-α治疗前和治疗期间定期对所有患者进行PET、计算机断层扫描和/或磁共振成像。计算肿瘤热点摄取与小脑摄取或皮质摄取的比值。该比率估计肿瘤中的相对甲硫氨酸积累，并推测肿瘤中的增殖活性。
结果
在IFN-α治疗期间，PET显示脑膜瘤中摄取率（MRelR）平均相对降低百分比为22.3%。在9例被视为缓解者（定义为MRelR阳性患者）的患者中，MRelR为30.4%。对于3例无应答者（定义为MRelR阴性的患者），MRelR为-1.8%。3例患者接受了长期随访：2例患者8年，1例患者4年6个月; 2例患者随访8年仍在使用IFN。这些肿瘤的体积是恒定的或显示出轻微的减少。脑膜瘤的组织病理学诊断（PAD）WHO分级I-III与IFN-α治疗反应之间无相关性。
结论
PET被认为是预测哪些患者适合长期使用IFN-alpha治疗以及剂量确定的有用方法。在5例治疗9个月至8年的患者中，IFN-α似乎是一种有效的抑瘤药物。考虑到不良反应，IFN-α的临床有用性必须在更大范围的患者中进行评估。
PURPOSE
In meningioma patients with postoperative residual masses, recurrent or primarily inoperable tumors, positron emission tomography (PET) with [(11)C]-L-methionine was used to evaluate treatment efficacy of IFN-alpha.
EXPERIMENTAL DESIGN
Twelve patients were treated with IFN-alpha at a dose of 1.5-5 million IU s.c. daily. PET, computed tomography, and/or magnetic resonance imaging were performed in all patients before and, at regular intervals, during IFN-alpha treatment. The ratio of tumor hot-spot uptake to cerebellar uptake or to cortex uptake was calculated. This ratio estimates the relative methionine accumulation in the tumor and presumably the proliferative activity in the tumor.
RESULTS
During IFN-alpha treatment, PET demonstrated a mean relative percentage of reduction in the uptake ratio (MRelR) of 22.3% in the meningiomas. In nine patients who were considered responders, defined as patients with a positive MRelR, the MRelR was 30.4%. For the three nonresponders, defined as patients with a negative MRelR, the MRelR was -1.8%. Three patients were followed for a long time: two patients for 8 years and one patient for 4 years and 6 months; the two patients followed for 8 years are still on IFN. The volumes of these tumors were constant or showed a slight decrease. No correlation was found between histopathological diagnosis (PAD) WHO grading I-III of meningiomas and response to IFN-alpha treatment.
CONCLUSIONS
PET was judged a useful method to predict which patients are suitable for long-term treatment with IFN-alpha and also for dose finding. In five patients treated from 9 months to 8 years, IFN-alpha seemed to be an effective oncostatic drug. The clinical usefulness of IFN-alpha, taking adverse reactions into account, must be evaluated in a larger series of patients.