Relationship Between Cancer Type and Impact of PET and PET/CT on Intended Management: Findings of the National Oncologic PET Registry
Relationship Between Cancer Type and Impact of PET and PET/CT on Intended Management: Findings of the National Oncologic PET Registry
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DOI：
10.2967/jnumed.108.056713
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发表时间：
2008-12-01
影响因子：
9.3
通讯作者：
Coleman, R. Edward
中科院分区：
文献类型：
--
作者：
Hillner, Bruce E.;Siegel, Barry A.;Coleman, R. Edward
我们以前报告的汇总数据显示，PET与参与国家肿瘤PET登记研究（NOPR）的超过三分之一的患者的预期治疗变化相关。在这里，我们介绍了特定癌症类型和测试适应症的结果。方法：NOPR从转诊医生那里收集了PET前后预期管理的问卷数据。数据来自1,368个中心的40,863项PET研究。按照类型和检测适应症（初始分期、再分期或疑似复发检测），评估PET对病理学确诊癌症患者中18种癌症类型的影响，而不是治疗监测。结果如下：当预期管理被分类为治疗或非治疗时，医生改变了38.0%病例的预期管理（95%置信区间= 37.6%-38.5%）。治疗变化的频率范围从骨髓瘤的48.7%到非黑色素瘤皮肤癌的31.4%。不同检测适应症的比较显示，只有在多发性骨髓瘤中，PET对预期治疗的影响始终较大。当PET前的预期管理计划是治疗时，不同癌症类型的治疗意图（治愈与姑息）或治疗方式的重大变化发生频率相似。结论：PET对医生对已知癌症患者的预期治疗的影响在不同癌症类型中是一致的。
We previously reported aggregate data showing that PET was associated with a change in intended management for over one third of patients participating in the National Oncologic PET Registry (NOPR). Here, we present results for specific cancer types and indications for testing. Methods: The NOPR collected questionnaire data from referring physicians on intended management before and after PET. Data were available from 40,863 PET studies done at 1,368 centers. The impact of PET was assessed for 18 cancer types in patients with pathologically confirmed cancer by type and indication for testing (initial staging, restaging, or detection of suspected recurrence), other than treatment monitoring. Results: When intended management was classified as treatment or nontreatment, physicians changed their intended management for 38.0% of cases (95% confidence interval = 37.6%-38.5%). The frequencies of changes in management ranged from 48.7% for myeloma to 31.4% for nonmelanoma skin cancer. Comparisons across testing indications revealed that only in multiple myeloma did PET have a consistently greater impact on intended management. When the intended management plan before PET was treatment, a change in the intent of treatment (curative vs. palliative) or a major change in the modality of treatment occurred at similar frequencies across different cancer types. Conclusion: The impact of PET on physicians' intended management for patients with known cancer was consistent across cancer types.