Posttherapy [18F] fluorodeoxyglucose positron emission tomography in carcinoma of the cervix:: Response and outcome
Posttherapy [18F] fluorodeoxyglucose positron emission tomography in carcinoma of the cervix:: Response and outcome
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DOI：
10.1200/jco.2004.09.035
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发表时间：
2004-06-01
影响因子：
45.3
通讯作者：
Zoberi, I
中科院分区：
文献类型：
--
作者：
Grigsby, PW;Siegel, BA;Zoberi, I
目的。本研究的目的是利用[F-18]氟脱氧葡萄糖（FDG）治疗后分子成像来评估对治疗的反应，并将反应与患者预后进行比较。患者和方法。这是对152例宫颈癌患者的回顾性医疗记录的回顾。所有患者在治疗前和治疗后都进行了FDG全身正电子发射断层扫描（PET）成像扫描。患者接受外照射和腔内近距离治疗，大多数患者每周同时接受顺铂治疗。治疗后全身FDG-PET于治疗结束后1 ~ 12个月（平均3个月）进行。114例患者治疗后PET未显示FDG摄取异常，其5年病因特异性生存率估计为80%。20例患者宫颈或淋巴结存在持续（照射区）FDG摄取异常。他们的5年病因特异性生存率估计为32%。18例患者出现新的解剖部位（在未辐照区域）FDG摄取异常，5年时没有患者存活。生存结果的Cox比例风险模型显示，与治疗前和治疗相关的预后因素相比，任何治疗后FDG摄取异常（持续或新发）是宫颈癌转移性疾病发生和死亡的最重要预后因素（P < 0.0001）。通过全身PET检测治疗后FDG摄取异常（持续性或新发）可测量肿瘤反应，并可能预测肿瘤复发和宫颈癌死亡。这些结果的前瞻性验证是必要的。(C) 2004年由美国临床肿瘤学会出版。
Purpose. The aim of this study was to evaluate response to therapy using posttherapy molecular imaging with [F-18] fluorodeoxyglucose (FDG), and to compare the response with patient outcome.Patients and Methods. This was a retrospective medical record review of 152 patients with carcinoma of the cervix. All patients underwent a pre- and posttreatment whole-body positron emission tomography (PET) imaging scan with FDG. Patients were treated with external irradiation and Intracavitary brachytherapy, and most received concurrent weekly cisplatin. Posttherapy whole-body FDG-PET was performed I to 12 months (mean, 3 months) after completion of treatment.Results. The posttherapy PET did not show any abnormal FDG uptake in 114 patients, and their 5-year cause-specific survival estimate was 80%. There was persistent (in the irradiated region) abnormal FDG uptake in the cervix or lymph nodes in 20 patients. Their 5-year cause-specific survival estimate was 32%. New anatomic sites (in unirradiated regions) of abnormal FDG uptake were present in 18 patients, and none were alive at 5 years. A Cox proportional hazards model of survival outcome indicated that any abnormal posttherapy FDG uptake (persistent or new) was the most significant prognostic factor for developing metastatic disease and death from cervical cancer when compared with pretreatment- and treatment-related prognostic factors (P < .0001).Conclusion. Posttherapy abnormal FDG uptake (persistent or new) as detected by whole-body PET measures tumor response and might be predictive of tumor recurrence and death from cervical cancer. Prospective validation of these results is warranted. (C) 2004 by American Society of Clinical Oncology.