FDG PET-CT相关参数对鼻咽癌预后影响研究

doi:10.3760/cma.j.issn.1004-4221.2016.03.003

摘要
图/表
参考文献()
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (430 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的鼻咽癌是一种具有特殊地域性分布和生物学行为的头颈部肿瘤,研究显示FDG PET-CT相关参数在高发区鼻咽癌预后中具有一定价值。本研究探讨FDG PET-CT相关参数对低发区鼻咽癌的预后价值。方法回顾分析2003—2013年在Albert Einstein医学院Beth Israel医疗中心诊治的 83例鼻咽癌患者资料,采用梯度法并依据PET-CT图像指导靶区勾画,获取FDG PET-CT参数 SUV_max、MTV、TLG。结果 3年样本数 37例,3年FFS率为74%,3年LRFS率为88%,3年DMFS率为85%。单因素分析结果显示 SUV_max、TLG是 3年LRFS和FFS的影响因素(P=0.004、0.014和 P=0.024、0.033),多因素分析结果显示 SUV_max是 3年FFS的影响因素。结论治疗前原发肿瘤 SUV_max是影响鼻咽癌患者FFS的因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王成涛
	欧阳斌
	张天
	董隽
	Kenneth S.HU
	文碧秀

关键词 ：体层摄影术, 正电子发射型, 最大标准摄取值, 糖酵解指数, 鼻咽肿瘤/放射疗法, 鼻咽肿瘤/化学疗法, 脱氧葡萄糖, 预后

Abstract： Objective At present,nasopharyngeal carcinoma (NPC) is a head and neck cancer with special geographical distribution and biological behavior. Studies have shown that ¹⁸F-FDG PET/CT parameters have certain prognostic values in patients with NPC in high-incidence areas. The aim of this study is to investigate the prognostic values of ¹⁸F-FDG PET/CT parameters in patients with NPC in low-incidence areas. Methods The clinical data of 83 NPC patients who were diagnosed and treated in Beth Israel Medical Center,Albert Einstein Medical College from January 2003 to December 2013 were analyzed retrospectively. Based on ¹⁸F-FDG PET/CT images,gross tumor volume (GTV) was delineated using the gradient method to obtain ¹⁸F-FDG PET/CT parameters:maximum standardized uptake value (SUV_max),metabolic tumor volume (MTV),and total lesion glycolysis (TLG). Results The number of patients followed was 37 at 3-years time. For all patients,the 3-year failure-free survival,locoregional relapse-free survival,and metastasis-free survival rates were 74%,88%,and 85%,respectively. The univariate analysis showed that SUV_max of the primary tumor (P=0.004) and TLG (P=0.014) were prognostic factors for 3-year locoregional relapse-free survival rate,and SUV_max of the primary tumor (P=0.024) and TLG (P=0.033) were prognostic factors for 3-year failure-free survival rate. The multivariate analysis showed that SUV_max of the primary tumor was the independent prognostic factor for 3-year failure-free survival rate. Conclusion SUV_max of the primary tumor before treatment is the independent prognostic factor for failure-free survival in patients with NPC.

Key words： Tomography,positron emission Maximum standardized uptake value Total lesion glycolysis Nasopharyngeal neoplasms/radiotherapy Nasopharyngeal neoplasms/chemotherapy Prognosis

收稿日期: 2015-01-06

基金资助:国家自然科学基金(81172209);广东省自然科学基金(S2011020003612)

通讯作者: 文碧秀,Email:wenbix@mail.sysu.edu.cn

引用本文:

王成涛,欧阳斌,张天等. FDG PET-CT相关参数对鼻咽癌预后影响研究[J]. 中华放射肿瘤学杂志, 2016, 25(3): 207-211.

Wang Chengtao,Ouyang Bin,Zhang Tian et al. Prognostic values of ¹⁸F-FDG PET/CT parameters in patients with nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(3): 207-211.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2016.03.003 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2016/V25/I3/207

[1] Xu ZJ,Zheng RS,Zhang SW,et al. Nasopharyngeal carcinoma incidence and mortality in China in 2009[J].Chin J Cancer,2013,32(8):453-460.DOI:10.5732/cjc.013.10118.
[2] 高黎,易俊林,黄晓东,等.鼻咽癌根治性放疗10年经验总结[J].中华放射肿瘤学杂志,2006,15(4):249-256.
Gao L,Yi JL,Huang XD,et al. Ten-year experience of radical radiotherapy for nasopharyngeal carcinoma:analysis of 905 patientes[J].Chin J Radiat Oncol,2006,15(4):249-256.
[3] 徐安安,韩非,卢丽霞,等.疗前FDG标准摄取值预测局部晚期鼻咽癌调强放疗疗效探讨[J].中华放射肿瘤学杂志,2012,21(3):209-213.DOI:10.3760/cma.j.issn.1004-4221.2012.03.005.
Xu AA,Han F,Lu LX,et al. The role of pretreatment FDG standard uptake value in predicting for clinical outcome in locally advanced nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2012,21(3):209-213.DOI:10.3760/cma.j.issn.1004-4221.2012.03.005.
[4] 黎静,潘艳东,尹吉林,等.¹⁸F-FDG PET/CT标准化摄取值与鼻咽癌临床分期和病理类型的关系[J].南方医科大学学报,2008,28(10):1923-1924.DOI:10.3321/j.issn:1673-4254.2008.10.046.
Li J,Pan YD,Yin JL,et al. Analysis of standard uptake values of ¹⁸F-FDG PET/CT in relation to pathological classification and clinical staging of nasopharyngeal carcinoma[J].J First Mil Med Univ,2008,28(10):1923-1924.DOI:10.3321/j.issn:1673-4254.2008.10.046.
[5] MacManus M,Hicks R,Bayne M,et al. In regard to Paulino and Johnstone:use of PET and CT imaging data in radiation therapy planning. Int J Radit Oncol Biol Phys 2004;59:4-5[J].Int J Radiat Oncol Biol Phys,2004,60(3):1005-1006.DOI:10.1016/j.ijrobp.2004.07.667.
[6] Delbeke D,Coleman RE,Guiberteau MJ,et al. Procedure guideline for tumor imaging with ¹⁸F-FDG PET/CT 1.0[J].J Nucl Med,2006,47(5):885-895.
[7] Larson SM,Erdi Y,Akhurst T,et al. Tumor treatment response based on visual and quantitative changes in global tumor glycolysis using PET-FDG imaging.the visual response score and the change in total lesion glycolysis[J].Clin Positron Imaging,1999,2(3):159-171.DOI:10.1016/S1095-0397(99)00016-3.
[8] Mao YP,Xie FY,Liu LZ,et al. Re-evaluation of 6^th edition of AJCC staging system for nasopharyngeal carcinoma and proposed improvement based on magnetic resonance imaging[J].Int J Radiat Oncol Biol Phys,2009,73(5):1326-1334.DOI:10.1016/j.ijrobp.2008.07.062.
[9] Liu MZ,Tang LL,Zong JF,et al. Evaluation of sixth edition of AJCC staging system for nasopharyngeal carcinoma and proposed improvement[J].Int J Radiat Oncol Biol Phys,2008,70(4):1115-1123.DOI:10.1016/j.ijrobp.2007.07.2353.
[10] 冯梅,范子煊,黎杰,等.582例鼻咽癌调强放疗5年远期疗效及预后分析[J].中华放射肿瘤学杂志,2011,20(5):369-373.DOI:10.3760/cma.j.issn.1004-4221.2011.05.003.
Feng M,Fan ZX,Li J,et al. Long-term results and prognostic factors in 582 nasopharyngeal carcinoma treated by intensitymodulated radiotherapy[J].Chin J Radiat Oncol,2011,20(5):369-373.DOI:10.3760/cma.j.issn.1004-4221.2011.05.003.
[11] 易俊林,高黎,黄晓东,等.416例鼻咽癌调强放疗远期生存与影响因素分析[J].中华放射肿瘤学杂志,2012,21(3):196-200.DOI:10.3760/cma.j.issn.1004-4221.2012.03.002.
Yi JL,Gao L,Huang XD,et al. Nasopharyngeal carcinoma treated by intensity-modulated radiotherapy:long-term results of 416 patients[J].Chin J Radiat Oncol,2012,21(3):196-200.DOI:10.3760/cma.j.issn.1004-4221.2012.03.002.
[12] Ou SH,Zell JA,Ziogas A,et al. Epidemiology of nasopharyngeal carcinoma in the United States:improved survival of Chinese patients within the keratinizing squamous cell carcinoma histology[J].Ann Oncol,2007,18(1):29-35.DOI:10.1093/annonc/mdl320.
[13] Qian CN,Zhang CQ,Guo X,et al. Elevation of serum vascular endothelial growth factor in male patients with metastatic nasopharyngeal carcinoma[J].Cancer,2000,88(2):255-261.DOI:10.1002/(SICI)1097-0142(20000115)88:2<255::AID-CNCR2>3.0.CO;2-N.
[14] Xia WX,Zhang HB,Shi JL,et al. A prognostic model predicts the risk of distant metastasis and death for patients with nasopharyngeal carcinoma based on pre-treatment serum C-reactive protein and N-classification[J].Eur J Cancer,2013,49(9):2152-2160.DOI:10.1016/j.ejca.2013.03.003.
[15] La TH,Filion EJ,Turnbull BB,et al. Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer[J].Int J Radiat Oncol Biol Phys,2009,74(5):1335-1341.DOI:10.1016/j.ijrobp.2008.10.060.
[16] Seol YM,Kwon BR,Song MK,et al. Measurement of tumor volume by PET to evaluate prognosis in patients with head and neck cancer treated by chemo-radiation therapy[J].Acta Oncol,2010,49(2):201-208.DOI:10.3109/02841860903440270.
[17] Liao CT,Wang HM,Chang JT,et al. Influence of pathological nodal status and maximal standardized uptake value of the primary tumor and regional lymph nodes on treatment plans in patients with advanced oral cavity squamous cell carcinoma[J].Int J Radiat Oncol Biol Phys,2010,77(2):421-429.DOI:10.1016/j.ijrobp.2009.05.002.
[18] Chan SC,Chang JT,Lin CY,et al. Clinical utility of ¹⁸F-FDG PET parameters in patients with advanced nasopharyngeal carcinoma:predictive role for different survival endpoints and impact on prognostic stratification[J].Nucl Med Commun,2011,32(11):989-996.DOI:10.1097/MNM.0b013e3283495662.
[19] Chan SC,Hsu CL,Yen TC,et al. The role of ¹⁸F-FDG PET/CT metabolic tumour volume in predicting survival in patients with metastatic nasopharyngeal carcinoma[J].Oral Oncol,2013,49(1):71-78.DOI:10.1016/j.oraloncology.2012.07.016.
[20] Wanet M,Lee JA,Weynand B,et al. Gradient-based delineation of the primary GTV on FDG-PET in non-small cell lung cancer:a comparison with threshold-based approaches,CT and surgical specimens[J].Radiother Oncol,2011,98(1):117-125.DOI:10.1016/j.radonc.2010.10.006.
[21] Geets X,Daisne JF,Tomsej M,et al. Impact of the type of imaging modality on target volumes delineation and dose distribution in pharyngo-laryngeal squamous cell carcinoma:comparison between pre-and per-treatment studies[J].Radiother Oncol,2006,78(3):291-297.DOI:10.1016/j.radonc.2006.01.006.
[22] Imamura Y,Azuma K,Kurata S,et al. Prognostic value of SUV_max measurements obtained by FDG-PET in patients with non-small cell lung cancer receiving chemotherapy[J].Lung Cancer,2011,71(1):49-54.DOI:10.1016/j.lungcan.2010.04.004.
[23] Liao XB,Mao YP,Liu LZ,et al. How does magnetic resonance imaging influence staging according to AJCC staging system for nasopharyngeal carcinoma compared with computed tomography?[J].Int J Radiat Oncol Biol Phys,2008,72(5):1368-1377.DOI:10.1016/j.ijrobp.2008.03.017.