Use of positron emission tomography in localized extremity soft tissue sarcoma treated with neoadjuvant chemotherapy
Use of positron emission tomography in localized extremity soft tissue sarcoma treated with neoadjuvant chemotherapy
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DOI：
10.1002/cncr.20769
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发表时间：
2005-01-15
期刊：
影响因子：
6.2
通讯作者：
Eary, JF
中科院分区：
文献类型：
--
作者：
Schuetze, SM;Rubin, BP;Eary, JF
背景高级别软组织肉瘤患者发生局部疾病复发和转移的风险很高。假设[F-18]-氟脱氧-D-葡萄糖（FDG）正电子发射断层扫描（PET）扫描可检测对治疗的组织病理学反应，并预测各种恶性肿瘤患者的肿瘤进展风险。采用连续FDG-PET扫描来确定接受四肢肉瘤综合治疗的患者的FDG摄取与患者预后之间的相关性。研究了46例高度局限性肉瘤患者。在接受新辅助化疗前和手术前测量肿瘤的最大标准化摄取值（SUVmax）。检查切除的标本中是否有残留的存活肿瘤。至少每年对患者进行一次随访，以寻找疾病局部和远处复发以及生存的证据。结果。基线肿瘤SUVmax大于或等于6且FDG摄取减少< 40%的患者具有全身性疾病复发的高风险，估计自首次诊断时起4年时复发率为90%。化疗后SUVmax下降40%的患者在完全切除和辅助放疗后复发和死亡的风险显著降低。FDG-PET扫描被认为是一种有用的方法，可以预测接受化疗的四肢高级别软组织肉瘤患者的预后。治疗前肿瘤SUVmax和新辅助化疗后SUVmax的变化可独立识别肿瘤复发高风险患者。FDG-PET扫描显示出作为一种工具来识别最有可能从化疗中获益的肉瘤患者的前景。(C)2004年美国癌症协会。
BACKGROUND. Patients with high-grade soft tissue sarcomas are at high risk of developing local disease recurrence and metastatic disease. [F-18]-fluorodeoxy-D-glucose (FDG) positron emission tomography (PET) scans are hypothesized to detect histopathologic response to therapy and to predict risk of tumor progression in patients with various malignancies. Serial FDG-PET scans were taken to determine the correlation between FDG uptake and patient outcomes in patients receiving multimodality treatment of extremity sarcomas.METHODS. Forty-six patients with high-grade localized sarcomas were studied. The maximum standardized uptake values (SUVmax) of tumors were measured before receipt of neoadjuvant chemotherapy and again before Surgery. Resected specimens were examined for residual viable tumor. Patients were followed up at least annually for evidence of local and distant recurrence of disease and survival.RESULTS. Patients with a baseline tumor SUVmax greater than or equal to 6 and < 40% decrease in FDG uptake were at high risk of systemic disease recurrence estimated to be 90% at 4 years from the time of initial diagnosis. Patients whose tumors had a 40% decline in the SUVmax in response to chemotherapy were at a significantly lower risk of recurrent disease and death after complete resection and adjuvant radiotherapy.CONCLUSIONS. The FDG-PET scan was found to be a useful method with which to predict the outcomes of patients with high-grade extremity soft tissue sarcomas treated with chemotherapy. The pretreatment tumor SUVmax and change in SUVmax after neoadjuvant chemotherapy independently identified patients at high risk of tumor recurrence. The FDG-PET scan showed promise as a tool to identify the patients with sarcoma who are most likely to benefit from chemotherapy. (C) 2004 American Cancer Society.